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Every analyst is familiar with Freud's frequently cited statement in “Inhibition, Symptom and Anxiety” that the problem of the obsessional neurosis remains unsurmounted. Most of us in reading this sentence must have felt that this is not so, and that the creator of psychoanalysis, who wrote it, himself made the greatest contribution to the understanding of this mysterious ailment. Whoever has read Freud's work on the obsessional neurosis, must recognize with awe and admiration that with his “shot in the dark” Freud hit the mark very successfully in precisely this field.
I assume that this very recognition has cramped many of Freud's followers. It is remarkable how little analysts—with exception of Jones and Abraham—have added to knowledge of the obsessional neurosis since Freud's basic discoveries. A further reason, among others, is probably the complexity of the phenomenon.
The following contribution to the therapeutic understanding of the obsessional neurosis is rather a desire to point out a frequent misconception, than an attempt to present something new. I therefore anticipate the objection that I do not consider the problem of the obsessional neurosis in its entirety. I am limiting myself quite deliberately to one detail—one, however, which I consider of decisive importance.
If an analyst who has had the necessary experience with obsessional neurotics is asked whether they are “aggressive”, he will say “yes”, and at the same time emphatically confirm the unconscious tendency of these patients to harm themselves. The usual analytic explanation of the connection between these two unconsciously determined tendencies is that these injuries, or constant unconscious guilt feelings, are a reaction against abundant aggression. Regarded genetically, the aggression is turned against the Ego under pressure of castration fears, or of the stern Super-Ego.