Chapter X. Clinical Contributions

In the course of years Freud made a number of short contributions, including descriptions of his cases, to the Vienna Society. Few of these have been published, but it is intended to publish the whole of the Minutes of that Society in Freud's time, and they will include also his contributions to various discussions.

The most important of Freud's clinical contributions in the present period are the classical case histories which will be discussed in the following chapter.

(1) Of the shorter ones the first was a paper, written in 1908 by request for the first number of Hirschfeld's new Zeitschrift fur Sexualwissenschaft,1 entitled ‘Hysterical Phantasies and their Relation to Bisexuality’. In it Freud stressed the basic importance of phantasies for the creation of hysterical symptoms. Such phantasies may be intimate day-dreams that have undergone repression or they may never have been conscious. Only unconscious phantasies can produce symptoms. Hysterical symptoms are nothing but unconscious phantasies that have come to expression through ‘conversion’. In long-standing cases a symptom may come to represent several such phantasies, provided the latter are themselves inter-connected.

Psycho-analytic investigation can regularly trace the source of these phantasies to the sexual life. They originally accompanied masturbatory acts, but may persist when these are abandoned. They are closely related, though in an inverse way, to sexual perversions because they spring from the infantile, as yet dissociated, components of the sexual instinct.

Freud summed up his experience on this subject in the following formulas:

1. An hysterical symptom is the memory-symbol of certain active (traumatic) impressions and experiences.

2. Hysterical symptoms are substitutes, produced through ‘conversion’, for the revival of these traumatic experiences by association.

   1. , VII, 189. , IX.

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3. Hysterical symptoms are, like other mental products, the expression of wish-fulfilments.