Freud's Early Clinical Theory (1894–1896): Outline and Context

The author points out that all Freud's publications and lectures from the period 1894–1896 had the aim of establishing an aetiological theory of the neuroses and psychoses. Freud found that the clinical pictures covered by the theory had a sexual aetiology and were distinguishable from each other by specific mechanisms. Numerous references are presented to show that what the author calls Freud's early clinical theory had its roots in contemporary neuropathology and psychiatry, and the prevailing views in these disciplines are discussed. He was able to build on the work of predecessors such as Möbius in regard to the causal role of psychic factors. Whereas Freud was of his time in attempting to redefine the category of ‘neurasthenia’ and adducing the familiar concept of ‘sexual noxae’, his originality lay in the elevation of these factors, hitherto seen as external, to the status of ‘true’ causes. In the author's view, the rejection met with by Freud's early clinical theory was due to its pre-experiential ‘vision’ of the sexual aetiology of the neuroses rather than to its content. She notes that Freud differed from his contemporaries on the concept of and systematic part played by sexuality, as well as on the central role of psychic mechanisms (i.e. of defence).