The Theory of Psychoanalysis

The apparent etiological development of neurosis, discovered by psychoanalysis, is in reality only the work of causally connected phantasies, which the patient has created from that libido which at times he did not employ in the biological adaptation. Thus, these apparently etiological phantasies seem to be forms of compensation, disguises, for an unfulfilled adaptation to reality. The vicious circle previously mentioned between the withdrawing in the face of difficulties and the regression into the world of phantasies, is naturally well-suited to give the illusion of an apparent striking causal relationship, so that both the patient and the physician believe in it. In such a development accidental experiences are only “extenuating circumstances.” I feel I must make allowance for those critics who, on reading the history of psychoanalytic patients, get the impression of phantastic elaboration. Only they make the mistake of attributing the phantastic artefacts and far-fetched arbitrary symbolism to the suggestion and to the awful phantasy of the physician, instead of to the unequalled fertility of phantasy on the part of the patient. Of a truth, there is a good deal of artificial elaboration in the phantasies of a psychoanalytic case. There are generally significant signs of the patient's active imagination. The critics are not so wrong when they say that their neurotic patients have no such phantasies. I have no doubt that patients are unconscious of the greater part of their own phantasies. A phantasy only “really” exists in the unconscious, when it has some notable effect upon the conscious, e. g., in the form of a dream; otherwise,