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January 11, 1897
IX., Berggasse 19
Dear Wilhelm,
I am sending you, red-hot, two ideas which occurred to me today and which appear to me to be viable; they are based, of course, on the results of analyses.
(1)The determination of a psychosis (that is, amentia or a confusional
psychosis — a psychosis of being overwhelmed, as I called it earlier)1 as opposed to a neurosis seems to be that sexual abuse occurs before the end of the first intellectual stage, that is, before the psychic apparatus has been completed in its first form (before the age of 1 1/4 to 1 1/2 years). It is possible that the abuse dates back so far that these experiences lie concealed behind the later ones and that they can be revived from time to time. Epilepsy, I believe, belongs to the same period (as in the dispute concerning Sophie, which I told you about). I shall have to deal differently with tic convulsif, which I previously assigned to the same stage. Here is how I arrived at this: one of my hysterical male patients (my millionaire) provoked in his eldest sister a hysterical psychosis which ended in a state of complete confusion. I have now traced his own seducer, a man of genius who, however, had had attacks of the severest dipsomania from his fiftieth year on. These attacks regularly started either with diarrhea or with a cold and hoarseness (the oral sexual system!) — that is, with the reproduction of his own passive experiences. Now, until he fell ill himself, the man had been a pervert and consequently healthy. His dipsomania arises through the intensification or, better, substitution of the one impulse for the associated sexual one. (The same is probably true of the gambling mania of old F.) Scenes took place between this seducer and my patient, in some of which his little sister (less than a year old) participated.2 The patient had relations with her later on and she became psychotic in puberty. You may gather from this how a neurosis escalates to a psychosis in the next generation — whic