Freud has conclusively demonstrated that it is the emotional life which furnishes the dynamic energy which guides and controls the actions of both normal and abnormal persons. Every case of hysteria is the result of a series of psychic traumas, occurring at some period in the life of the neurotic, and these represent the steps in the development of the neurosis. No single experience can be responsible for the symptoms manifested, but usually several or many, each contributing to the effect of the former experiences. Every experience which produces the painful effect of fear, anxiety, shame, or other psychic pain may act as a psychic trauma. The psychic trauma, or the memory of the same, acts like a foreign body, which, even long after its penetration, must continue to act like a new causative factor.

According to Freud, the etiologically effective traumas from which hysterical symptoms are derived reach to experiences which belong to the patient's childhood and concern his sexual life. Even where a banal emotion of a nonsexual nature has occasioned the outburst of the disease, this can be traced back to the sexual traumas of childhood.

"The incomparable significance of sexual experiences in the etiology of the psychoneuroses seems therefore firmly established, and this fact remains until today one of the main supports of the theory." 1

In the application of psychoanalysis for the relief of the psycho-neurosis it is necessary to reproduce from the subconscious into the conscious memory of the patient the entire series of pathogenic memories in chronological order, the last coming first and the first last.

The nervous system faithfully conserves the experiences and "complexes" resulting from the emotional excitations during the life of the patient - stand like monuments, conserving the original experiences - so that hysterical patients suffer from conscious or unconscious reminiscences, from which they are powerless to escape. This conservation and fixation of the experiences producing the psychic traumas are the essential characteristics of the neurosis. When these complexes are stimulated, the patient is under the embarrassing situation of having to suppress strong feelings, or he must give vent to them in conscious words or actions. Only childhood experiences can explain the excessive sensitiveness to later traumas, and only when these memory traces, which are almost always forgotten, are discovered and made conscious is the power developed to banish the symptoms.

1 Hysteria and Other Psychoneuroses. - Translation by Brill, page 188.

Freud further tells us that, as a protective measure, the individual receiving a psychic trauma attempts to force out the painful and disagreeable idea from his conscious memory, resulting frequently in a splitting off from the main content of the conscious personality, the complexes conserving the experience. Though submerged below the threshold of consciousness, these emotional complexes take on an automatic or independent activity. Thus the individual, being unaware of the functionating of the complexes conserving the emotions, feeling tones, and other sensations, is harassed by neurotic manifestations, to be reproduced in his conduct as often as they are stimulated by similar associations. In the same individual several mental groupings are possible, functionating independently of each other, presenting, it may be, a double or multiple personality. When such splitting occurs, the conscious personality represents one or the other of the respective mental groups, while the other, or others, remains unconscious.

The hysterical is incapable of correlating and unifying the various mental states resulting from his manifold experiences - hence his tendency to mental dissociation.

Freud employs suggestion by the induction of a state of suggestibility which might be regarded as a light hypnosis, though he claims no similarity to this condition of abstraction to hypnosis, to revive from the subconscious the forgotten experiences, frequently having considerable resistance to overcome, before extorting from the subconsciousness memories that were apparently lost. On this idea is based his theory of the psychic mechanism of hysteria. In order to cure his patient, it was only necessary to bring to bear suggestion with sufficient effectiveness to exact from the subconsciousness the memory of the pathogenic experiences that had been crowded out of the consciousness of the patient by the repression process, which he regards as characteristic of the mechanism of hysteria. He informs us that in all such experiences it happened that a wish had been aroused, which was in sharp opposition to the other desires of the individual, which was not capable of being reconciled with the ethical, esthetic, and personal pretensions of the patient's conscious personality; that there had been a short conflict, and the end of the inner struggle was the repression of the idea which presented itself to the subconsciousness as the bearer of this irreconcilable wish.

This was, then, repressed from consciousness and forgotten. The incompatibility of the idea in question with the "ego" of the patient was the motive for the repression - the ethical and other pretensions of the individual were the repressing forces.

The presence of the incompatible wish, or the duration of the conflict, Freud considers, had given rise to a high degree of mental pain, which pain was avoided by repression. The later process is evidently in such a case a device for the protection of the conscious personality. However, the repressed presentation then avenges itself by becoming pathogenic, and the hysterical symptom is a species of self-gratification. The disagreeable idea is rendered harmless to the conscious personality of the hysteric because the force of the trauma is transformed into physical manifestations, a process which Freud designates as conversion.