Letter 1052 from Extracts from the Fliess Papers

… My last generalization3 has held good and seems inclined to grow to an unpredictable extent. It is not only dreams that are wish-fulfilments but hysterical attacks as well. This is true of hysterical symptoms but probably of every neurotic event too, for I recognized it long ago of acute delusional insanity.4 Reality-wish-fulfilment. It is from this pair of opposites that our mental life springs. I believe I now know what determines the distinction between dreams and symptoms, which make their way into waking life. It is enough for a dream to be the wish-fulfilment of the repressed thought, for dreams are kept apart from reality. But a symptom, set in the midst of life, must be something else besides: it must also be the wish-fulfilment of the repressing thought. A symptom arises where the repressed and the repressing thought can come together in the wish-fulfilment. A symptom is the wish-fulfilment of the repressing thought when, for instance, it is a punishment, a self-punishment, the final replacement of self-gratification, of masturbation.

This key opens many doors. Do you know, for instance, why X.Y. suffers from hysterical vomiting? Because in phantasy she is pregnant, because she is so insatiable that she cannot put up with not having a baby by her last phantasy-lover as well. But she must vomit too, because in that case she will be starved and emaciated, and will lose her beauty and no longer be attractive to anyone. Thus the sense of the symptom is a contradictory pair of wish-fulfilments.5

Do you know why our friend E.,6 whom you know, turns red