You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
I have had the opportunity of studying the problem of symptom-formation and of the ego functions in cases of disturbances of sexual potency in men. In these disturbances the validity of our concepts of defence- and adaptation-mechanisms of the ego can be well demonstrated. As you know, Freud chose in the introductory part of his study on Inhibitions, Symptoms and Anxiety the inhibitions of the sexual function as examples to demonstrate disturbances of the ego functions. Disturbance of potency in the male is an inhibitory phenomenon expressing itself in various ways, the most conspicuous being erective impotence and premature ejaculation. Freud says that the latter can also be described as a 'positive symptom', not only as an inhibition. Elaborating the idea of the relationship between the various neuroses and the mechanisms of defence, Anna Freud (1936) points out that repression is the characteristic mode of defence in hysteria. We are tempted to regard disturbances of potency as a hysterical conversion, but certain observations warn us to caution. At any rate, repression as a mechanism of defence is undoubtedly operative in this sexual inhibition. Analysis reveals regularly pregenital instinctual demands, oral and anal fixation, aggressive impulses and, above all, incestuous wishes with corresponding castration fear as the motivational forces of the defence mechanisms instituted by the ego.
We frequently meet with the formulation that the symptom is produced by the 'pathological defence mechanisms', by the 'pathological use of defence'. I think these formulations are open to question. The ego employs defence mechanisms, in the case of sexual inhibition the mechanism of repression, to ward off 'dangerous' instinctual demands and their representatives. However, it is not the mechanism of repression as such that is pathological, but the outcome of the conflict between the instinctual demands on the one hand and the ego and superego on th