Page:The International Journal of Psycho-Analysis II 1921 1.djvu/22

 14 S. FERENCZI

on by Meige and Feindel.¹ The "ego-memory system", as well as the system of memory for things, belongs in part to the unconscious and in part extends into the preconscious or into consciousness. To explain the symptom formation in Tic one must suppose a conflict inside the ego (between the ego-nucleus and narcissism), and a process analagous to repression.²

We must regard the symptoms of traumatic neurosis as a mixture of narcissistic phenomena and phenomena of conversion-hysteria, and we are in agreement with Freud that they consist in essence of in- completely mastered shock affect, repressed and carried over, abreacted little by little ; in addition they show a marked simi- larity to the "pathoneurotic" tics. I should Uke, however, also to call particular attention to a remarkable resemblance between the two. Practically all students of the war neuroses agree that neuroses occur almost only after shock without severe physical injuries (wounds). Shock complicated by wounds is provided with a corresponding discharge for the shock affect and a favourable path for the distribution of the libido in the organism. This led Freud to form the hypothesis that the addition of severe physical wounds (e. g. a fracture) must expedite the cure of traumatic symptoms. Compare with this the following case-history.³ "Young M...., who suffered from tic of the face and head, fractured the lower part of the thigh; during the time that his leg was set the tics ceased entirely." The authors consider that this is owing to the attention being diverted ; according to our opinion it is due to the diversion of the libido as well. Both views are compatible with the fact that tics can give way before "im-

¹ Idem., Op. cit., pp. 5 and 6, Compare also Psycho-Anulysis and the War Neuroses, 1921, (International Psycho-Analytical Library, No. 2) sec also "Obcr zwei Typen der Kricgshysteriu" (Hysterie uad Pathoneuroscn). The mental difference between the manner in which an hysteric and a narcissist register the memory of the same experience reminds us of an anecdote of two sick nurses who were on duty with the same patient on alternate nights. The one reported early in the morning to the doctor, that the patient had slept badly, had been restless, had asked for water so and so many times, etc. The other received the doctor with the words: "Doctor 1 have had such a bad night!" — The tendency to auto-symbolism is also occasioned by narcissism (Silberer).

² We have also met with cases of conflict between ego and libido, inside the ego and inside the libido.

³ M. and F., Op. cit., p. 111.