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The first beginnings of psychoanalysis go back to the concept of "conversion hysteria", in which psychological factors cause bodily symptoms; in fact, one of the first psychoanalytic case histories of Freud, the case of Dora, is devoted to the explanation of somatic symptoms from unconscious psychic influences.
Freud's original view of hysterical conversion has been already described in the second chapter of this book.1 The essence of this theory is that every psychic tendency seeks adequate bodily expression. The normal way of such expression goes through the system which is called the conscious ego, which is probably localized anatomically and physiologically in the cortex. The conscious ego has control over those muscle innervations which serve to relieve psychic tensions that originate from our biological needs. All our voluntary innervations serve to satisfy these needs by appropriate activity. There is also a series of automatic psychomotor phenomena which serves to express emotional excitation such as weeping, laughing or blushing. If the passage through these normal channels is blocked, i.e., an emotional tendency is repressed, an unusual relief comparable to a short circuit takes place in the form of an unconscious innervation. This is the hysterical symptom. It gives symbolic expression to the repressed wish or wishful fantasy, and thus serves as a substitute for a voluntary