Page:The International Journal of Psycho-Analysis II 1921 1.djvu/29

 PSYCHO- ANALYTICAL OBSERVATIONS ON TIC 21

catalepsy does the patient acquire that degree of fakir-like con- centration on the inner ego when even his own body appears as something foreign to his ego and is perceived as a part of the environment, whose fate leaves its owner absolutely cold. Catalepsy and Mimicry therefore would be regressions to a much earlier primitive method of adaptation of the organism, an auto-plastic adaptation (adaptation by means of alteration in the organism itself), while flight and defence aim at an alteration in the environ- ment (allo-plastic adaptation).^

According to the description in Kraepelin's Textbook on Psychiatry catatonia is often a remarkable mixture of symptoms of imperative automatism and negativism as well as of (tic-like) movements ; this would suggest that different methods of motor tension reactions can be present in one and the same case. (Of the stereotyped movements of catatonic patients, which we should describe as tic-like, Kraepelin mentions the following: "Pulling faces, twisting and dislocating the limbs, jumping up and down, turning somersaults, rolling about, clapping the hands, running about, climbing and skipping, uttering senseless sounds and noises." Kraepelin, 'Textbook on Psychiatry', 6th. Edition, Book I.)

In an endeavour to explain Echopraxia and Echolalia in dements and tic patients one must take into consideration the more subtle processes of Ego-psychology to which Freud has drawn our attention.* "The development of the ego consists in a separation from primary narcissism and engenders an intensive struggle to regain this. The separation comes about by means of an enforced displacement of libido on to an ego-ideal, and satisfaction comes from fulfilment of the ideal."

Now the fact that the dement and the liqueur both possess such a strong tendency to imitate everyone in word and action, taking them as it were for an object of identification and ideal, seems to be in opposition to the assertion that they have regressed to the stage of primary narcissism or have never advanced beyond it. This opposition is, however, only apparent. Like other blatant symptoms of Schizophrenia, these exaggerated expressions of the identification-tendency serve the purpose of concealing the lack of real interests ; they act, as Freud would express it, in the

1 See "Hysterische Materialisationsphanomene" in Hysterie und Patho- neurosen, S. 24.

= Freud: Samml. kl. Schr., 4<'- Folge, S. 109.