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Vienna, December 9, 1899
IX., Berggasse 19
Dear Wilhelm,
My thirst for personal data about you is somewhat assuaged by your recent presence here. So I feel free to turn to scientific matters.
I may recently have succeeded in gaining a first glimpse of something new. The problem confronting me is that of the “choice of neurosis.” When does a person become hysterical instead of paranoid? In my first crude attempt, made at a time when I was still trying to take the citadel by force, I thought it depended on the age at which the sexual trauma occurred — the person's age at the time of the experience. That I gave up long ago; but then I was left without a clue until a few days ago, when I saw a connection with the sexual theory.
The lowest of the sexual strata is autoerotism, which dispenses with any psychosexual aim and seeks only locally gratifying sensations. It is then succeeded by alloerotism (homo- or heteroerotism), but certainly continues to exist as an undercurrent. Hysteria (and its variant, obsessional neurosis) is alloerotic, since its main path is identification with the loved one. Paranoia again dissolves the identification, reestablishes all the loved ones of childhood who have been abandoned (compare the discussion of exhibitionistic dreams), and dissolves the ego itself into extraneous persons. So I have come to regard paranoia as a forward surge of the autoerotic current, as a return to a former state. The perversion formation corresponding to it would be the so-called idiopathic insanity. The special relations between autoerotism and the original “ego” would throw a clear light on the nature of this neurosis. At this point the thread breaks off again.
Two of my patients have almost simultaneously come up with [self-]reproaches following the nursing and death of their parents and have shown me that my dreams about this were typical. The reproach is in every instance bound to attach itself to revenge, spiteful glee, taking satisfaction in the ill person's excr