Revue Française De Psychanalyse. XXXVII, 1973: The Economic Point of View in Hysteria and the Concept of Trauma in Freud's Work. Jacqueline Lubtchansky. Pp. 373-405.

Lubtchansky considers hysteria as organized economically around two traumatic kernels. Bound energy goes into the symptom, while unbound energy in involved in the characteristic acting out behavior and the lability that makes for so much difficulty in the treatment of hysterics. This unbound energy often leads to the interruption of therapy or to a negative therapeutic reaction. Lubtchansky argues that hysterics suffer not only from traumatic events and conflicts which are sexual in character and inadequately dealt with; hysterics have also suffered a painful loss occurring at the stage of phallic organization, a loss which, had it occurred earlier, would have led to psychosis. The excitation accompanying such a loss was so great that it was perceived as sexual and orgastic and unconsciously equated with a passively experienced seduction. Hysteria is thus the result of a struggle to master this excitation, in much the same manner as the traumatic neuroses. Many hysterical symptoms result from the effort to translate such instinctual arousal into psychical material. If this effort is successful we have the creation of fantasy and the familiar symptomatology of conversions and phobias. But another defensive system develops from the failure to achieve such symbolization and results in dramatic re-enactment in the reproduction of the trauma rather than the elaboration of impulses in fantasy. In analysis this tendency exists as a resistance, but is extremely important and must be analyzed.