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The main effect of a traumatic shock, according to the author, is that the accumulated unconscious impulses and affects, which have not been able to find an outlet, are stirred up by the experience coming from without. In consequence, genital libido and Pcpt.-Cs. cathexes have to be withdrawn and used to keep those impulses under repression. (Two diagrams are given to depict this contrary flow of libido in a traumatic situation and a non-traumatic one). In this way, not only does the libido regress to a pre-genital stage, causing impotence, but some of the pre-genital libido is called in as well. The ego, too, regresses and old defensive reactions come into play once more. In fact, the whole synthetic function of the ego is reversed. A part of the new ego-cathexes themselves become unconscious—or, as the writer puts it, introjected. This depletes the anti-cathexes in the ego, so that former ego-positions become mixed with instinctual quantities belonging to the unconscious. The ego-structure is inundated by narcissistic libido and ego-functions become eroticized.
The writer does not think that the machinery of traumatic processes is different from that of the transference neuroses, since in both it is the excitation itself of the unconscious trends—i.e. the return of the repressed—and not the occasion of that excitation—i.e. the breaking through of external stimuli—which is the important thing. It is true that in the traumatic neuroses the external stimuli are so strong and sudden that the cathexes which the ego has to make have to be much more extensive and rapid than in the transference neuroses. Nevertheless those cathexes are of a sexual nature and similar in kind to the cathexes involved in the non-traumatic neuroses.
On the other hand, the therapy of traumatic neuroses, which is at present almost non-existent, does, he believes, require a different machinery from what is used for the transference neuroses. It should be of a hypnotic and cathartic natu