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The object of this paper is the investigation of why one individual becomes hysterical and another develops obsessional symptoms. I shall not specially discuss whether it is necessary to state such a difference. If we can find a differential diagnosis between both diseases one is then justified in separating them. I shall try to base the diagnostic differentiation not on symptoms but on main differences in the genesis of the symptoms themselves. From the beginning of this work Freud was very much interested in the question which he has called the problem of the “Neurosenwahl: the choice of a neurosis.” Freud and all who follow him in this regard stick to the progressive view of classifying the different reversible mental disturbances and not to return to the former views of covering all reversible organic disorders with the commonplace nominations of “neurasthenia,” “hysteria,” and recently, “neurotic state.” Freud used his methods to single out especially anxiety-neurosis from neurasthenia and obsessions from hysteria. In hysteria itself he separated hysteria in its narrow sense and anxiety hysteria, generally known under the name of phobia. I begin with showing some specific differences between hysterical and obsessional states. Conversion symptoms like contractures, paresis, vomiting, pains, fits, trance-states, and the hysterical stigmas—hemianesthesia for instance—will be diagnosed by every physician as hysterical symptoms, while typical ceremonials and rituals doubtless belong to obsessional neurosis.
But there are symptoms which bear features of both diseases and cannot as easily be made to fit into one of them. The muscular tics are such a group. Tics are forced upon the individual like an obsession