Comment on Dr Haas's Paper1

I am very grateful to Haas for having drawn attention to the problem of the secondary defensive struggle against the symptom. Freud's seminal thoughts about this question have, in my opinion, not been elaborated and not followed up in the psychoanalytic literature to the degree they deserve. Instead, another kind of sequel of symptom formation, the secondary gain, has attracted the attention of psychoanalysts. Haas states as his main thesis that whereas various sexual perversions may be manifestations of neurotic illness they are also used as methods of defence to ward off anxiety and inhibitions in sexual activity; they are used as sexual stimulants to provoke or support potency. Fantasy, he says, has special significance in these processes.

In Inhibitions, Symptoms and Anxiety, Freud, as Haas reminds us, gave a systematic account of the secondary reactions of the ego to the symptom, and outlines the main methods it may use. The ego may (i) adjust itself to the symptom, accept it, incorporate it into its own organization; (ii) isolate the symptom from the rest of the personality; or, (iii) avoid functions in which the symptom is involved. The phenomena which are the object of Haas's paper are in my opinion example of a combination: the ego adjusts itself to the symptom (impotence), but does not succeed in incorporating it into its own organization. The symptom remains outside the organization of the ego.

To illustrate his thesis, Haas presents three very condensed case histories. All three are middle-aged married men. All three have been impotent, and had no premarital heterosexual experiences. In their marriages they succeeded in eliciting and maintaining erection and reaching orgasm by using perverted fantasies, as in masturbation, during intercourse. The analysis reveals repressed incestuous wishes, castration anxiety, and feminine identification. There are repressed sadomasochistic tendencies, transvestitism and fetishism too. The perverted fantasie