By these who have studied Freudism this will, in a way, be understood. For these who have not it may be more difficult of understanding without somewhat further elaboration or explanation. In this connection I must again mention that the Freudians include tics under their obsessive (obsessional) neuroses. The theory of the mental mechanisms and evolution of these states is given in the attached quotation, which is taken verbatim from Clark's paper.

"The affect of the painful idea does not become transformed into physical symptoms, as in the conversion mechanism of hysteria, but affixes itself to other ideas not in themselves unbearable, thus producing by this false relationship a substitutive symptom or obsession.

" . . . In all such obsessive neurotics the transformed reproaches which have escaped repressions are always connected with some pleasurably accomplished sexual act of childhood but may be almost entirely lost. The obsessive acts really represent the conflict between impulses of opposite instincts, love and hate, which are usually of equal value. The warring conflict engendered makes for a curiosity to discover the meaning of life forces (sexual largely) and the desire to know the end thereof. The nuclear-complex of all this is a precociousness of emotional life and an intensive fixation on one or the other parent or brother or sister. The intensive love fixation waxes the stronger as the unconscious hate requires increased barriers against its breaking through into the main or everyday personality. As a result of these conflicts the will is partially weakened, there is an incapacity for resolution, first in the realm of love alone; then later succeeds a diffusion or displacement of the mechanism all over the field of activity. A series of secondary defense mechanisms are now brought in and these may enable the obsessive person to get square in a limited way (as religious practices enable many to do). Some special adaptation is required sooner or later, and the individual, having used up all the helps, then falls back upon the different forms of obsessive acts and thinking. Thus the obsessive neurosis is generated."

Clark then proceeds to explain:

"If one is not permitted to draw deductions from a few data as to the further genesis of the tic disorders, we may still hold out a tentative hypothesis, pieced together from many sources that a certain type of nervous make-up is inherited. In such the emotional life is precocious much beyond the intellectual faculties. The ticquer in infancy has the emotional feelings of love and hate of an adult. Their very precociousness aids the parental fixation and adhesion, and makes it the more difficult for the libido to detach itself at the proper age. One should bear in mind that the parental fixation in itself does not directly produce the mishaps of adult life but this small fault in infancy generates wider and wider maladaptations as development progresses. It is these latter glaring faults and trends that make for the character defects, and these really break down the final effort at adaptations and adjustments producing the tic or obsessive disorder. But the essential nucleus of the defect is lack of balance, precocious parental fixation, and continued attachment to the parent-stem, that makes the adult defect possible. The very infantile precociousness of the emotions argues for the hereditary transmission of destructive temperamental qualities. Here, as elsewhere in tracing hereditariness in so-called functional nervosities, one should take as the unit character for study the mental traits or trends and exclude definite disease entities applied to ancestral disorders. I believe it is not too suppositious to think that many of these variant individuals are really atavistic in makeup and have continued from one generation to another special defective traits of emotional makeup which are fortunately denied the average individual."

The writer cannot understand how the theory which he has taken the trouble to so fully present in the above quotations can be maintained. Jones and Clark both assert that the tics or habit spasms as probably of the same nature as the obsessions in general. Moreover, Jones agrees that "familiar examples of compulsion in a slight degree are the obsessive impulses to touch every other rail of an iron fence as one walks past, to step on the cracks between the flagstones of the pavement, or not to step on them, and so on." A little reflection will show us the impossibility and illogicality of viewing all these conditions as being fundamentally of sexual origin. Let us follow the argument. If tics are of sexual derivation, as the Freudians here openly maintain, then it must follow that those familiar examples of compulsion, such as the obsessive impulse to touch every other post, etc., are likewise of sexual origin. This conclusion is forced upon us, since, even according to Jones, the only difference between the marked tics and the lesser manifestations is one of degree.[*] Now, these slighter impulsive tendencies to which we have here referred are very frequent in all children and by no means infrequent in grown-ups. They are habitual movements, which may be of transient duration only or may, by repeated performance, develop into more or less fixed habits. If, then, these habits are of sexual significance, it must follow that all other habits, especially if associated with a certain degree of consciousness or awareness, are in like manner symbolical of the past infantile and early childhood sexual activities and tendencies. This conclusion is, as is seen, inevitable, if we believe in the Freudian theory of the pathogenesis of the tics. However, since this leads us to a reductio ad absurdum, we must, of course, reject the explanation which has been offered by the Freudian school.

[*] The accompanying mental state characteristic of ticquers is absent in habits. We can stop doing the latter when our attention is directed to them; not so in tics Meige and Feindel have discussed these and other differences.

Perhaps I should also mention the fact that all of these symptoms or tendencies which one finds in ticquers occur in other individuals who do not present tics; and, furthermore, that all normal individuals possess these qualities or tendencies in varying degrees of intensity and in varying combinations, and that this applies to adults as well as to children, although, of course, they are seen most characteristically in children. I may further add that the difference between the mental infantilism which we find present in the tic psychoneurosis and that which we observe in other (normal and abnormal) conditions is one of degree rather than of kind. Therefore, the most we can say of the mental condition in ticquers is that there is an exaggeration of the mental infantilism or a fixation at or tendency toward regression to this type of thinking or of reaction. And this leads us to the further conclusion—and it is this point which I desire to bring out in this connection—namely, that since the difference between the mental infantilism in all of these conditions is relative, being one of degree and of proportionate relationship or at any rate of genesis, evolution and meaning, it naturally follows that what is in the conclusions of Clark, as mentioned above, asserted to be an absolute and basic principle or truth applicable to the tics, must consequently be true, but in different degree, of all the other conditions of a similar or allied nature. Surely the motive source is fundamentally the same in all of these conditions.

Furthermore, tics occur in animals, especially in horses; and the whole picture, physical and mental, of tics in horses resembles that which we find in human beings, particularly idiots and imbeciles, with tics. And the ultimate, fundamental meaning and motive source of tics in man is and must be the same as that of tics in horses.

To put Clark's idea in a nut-shell, it may be said that he believes that the primary purpose of tics is not that of a protective, defense mechanism against unpleasant situations in life but that of obtaining really pleasurable gratifications to the psyche, these autopleasurable acts being based on inherent defects and having a sexual significance in the sense in which sexuality is conceived by Freud. The protective, defense mechanism is, according to this view, but secondary to the primary and fundamental purpose of obtaining the autopleasurable gratifications to the psyche.

Although approving of the analytic and genetic tendency displayed by Freud, Clark and the Freudian school in general, it is regrettable to me that the analytic tendency and reconstructive efforts of the Freudians in the field of neurology and psychopathology have been seriously marred by their insistence on forcing all observed physical and psychical phenomena and reactions into line with their fixed sexual theories and their special psychology, which is basically wrong in many fundamental and important standpoints.

The writer will agree with the Freudians that there must be a cause for the appearance of these tics. This cause existed in the past. It has in the course of time been forgotten, but still exists somewhere in the subconsciousness or memory. This forgetting has been brought about by a process of dissociation from the original exciting cause. But the writer will not agree that this dissociation has been, of necessity, brought about by psychic repression on the part of the individual, that by psychoanalysis the condition can be traced back to the sexual activities or tendencies of infantile or early childhood origin, or that the condition may be cured when the original cause is made known to the patient through psychoanalysis, without the training of the will so necessary in this condition.

Thus the analytic tendency of the Freudian school is to be highly commended. But this analysis should not be limited to sexual analysis, but should include a consideration of all of man's instincts. Nor should the analysis be limited to present-life psychic factors alone, but should be viewed from a psychobiological standpoint. In this way only will all antecedent causative factors—physical and mental—be included in our analytic observation and speculation.

To fully discuss or to prove the error of Clark in his conclusions would necessarily lead me into a general discussion of Freudism, which I cannot do in this place, since the ramifications are too numerous and the problems involved would lead to lengthy and tiresome discussion, pro and con. I must, however, mention the exclusively sexual standpoint assumed by the Freudian school in their interpretations of physical and psychical activities, their classifying of all activities characterized by a certain rhythmicity and periodicity, and accompanied by a certain degree of satisfaction— in other words of all autopleasurable activities—as sexual (in the Freudian sense), and the neglect of comparative and behavioristic psychology with proper consideration for man's phylogeny and ontogeny or of his true genetic history, from the racial and world history and not alone from the individualistic psychological standpoint. As a matter of fact the conception of sexuality assumed by Freud and his followers has undergone many changes and is by no means definite and clean cut in its outlines. A criticism of the conception of sexuality cannot be entered upon here. I may merely state that what is an absolute and fixed law for the tics, what is the fundamental and basic explanation or theory of the genesis and meaning of the tics must apply also to all habit movements wherever and whenever they occur, and, in like manner, to all habit formations of whatever nature. And since our habits are but the prolongations of our instincts, the latter also would be included within the purview of the same generalization. In other words, if all tics have a sexual meaning, then all instincts, which means the vital energy of man, has the same meaning. This question I have discussed in another place[7] and cannot enter upon here.

[7] A Critical Review of the Conception of Sexuality Assumed by the Freudian School. Medical Record, March 27, 1915.

Without furthur elaboration or discussion I am content to give the Freudian conception to you as I have outlined it above and to let it stand for what it is worth.

I may say that in the physical aspect of tics we have a specific somatic manifestation which, if explained, should, in a way, be the gateway toward the understanding of the many somatic symptoms which we find in the psychoneuroses and psychoses.



THE EVOLUTIONARY, PHYLOGENETIC STANDPOINT

A year or more before Clark's paper appeared, I had arrived at certain general conclusions regarding the subject of tics.

G. Stanley Hall has arrived at similar conclusions in his inspiring Synthetic Genetic Study of Fear[8] and I wish here to acknowledge my indebtedness to his paper for making my own ideas clearer to me, for having given me broader standpoints and for clearly presenting a theory which shall form the basis of the remainder of this paper.

[8] In the American Journal of Psychology, Vol. XXV, in the July issue et seq.

Let us first take up the tic movements and see whether we can arrive at a rational explanation for their appearance.

The different varieties of tic movements embrace the entire field or range of systematic, physiologically coordinated voluntary muscular activities.

The main types of tics may be enumerated at this point: facial tics, which are the most frequent and which may be tonic or clonic, are tics of mimicry and express emotions; tics of the ear or auditory tics; nictitation and vision tics, particularly of the eyelids; tics of sniffing; tics of sucking; tics of licking; tics of biting and of mastication, and mental trismus; tics of nodding, tossing, affirmation, negation, salutation and mental torticollis; trunk, arm and shoulder tics; snatching tics; the professional or occupational spasms, which are really a special atypical form of tics; walking and leaping tics; tics of spitting, swallowing, vomiting, eructation and wind sucking (aerophagia); tics of snoring, sniffing, blowing, whistling, coughing, sobbing, hiccoughing; tics of speech, including all sorts of sounds, stammering (in some cases), habit expressions, echolalia and echopraxia.

It is thus seen that we have here physiological and biological acts of different manifestations and purposes.

The tic movements have a certain significance at the time of their performance. The physiological functions are definite.

The Magnan school insisted that tics are not morbid entities but episodic syndromes of mental degeneration. Charcot referred to tic as a sort of hereditary aberration, which, I may add, is surely true when we view it from the phylogenetic standpoint, as representing a resurrection of what was at one time a normal tendency or reaction. Noir has called attention to the fact that the movements found in the tics correspond to the infant's spontaneous muscular play, which means the muscular play of all mankind.

These authors were directing their efforts in the right direction. To appreciate this we need but remember that the mechanisms or the potentialities for the movements are inherited and have a phylogenetic significance. At a lower psychic level, far back in our phylogenetic racial history, all of these movements, perhaps then in a rudimentary form, had a single, original meaning. This meaning was self-preservation, and it was because of its value as a means of adaptation or reaction to the environment, with the consequent maintenance of self-preservation; that the movements or the mechanisms of the movements were selected for survival and for hereditary transmission as inherent, unconscious, organic mechanisms, processes or engrams. The original, phylogenetic significance attained at a low cultural or psychic level, relatively unconscious, may or may not later be consciously associated or dominate its subsequent functioning. But its primary, biological significance, its real raison d'etre is to be found in the phylogenetic, racial history of man. The present life history with its varied experiences do but act as stimuli or as exciting factors to bring once more into activity functions which have been preserved in the organic structure of the nervous system.

In our return to phylogenetic, ontogenetic, rudimentary, unconscious, organic reactions, to atavistic, prehistoric, performed, embryonic, immature methods of response, the vestigial remnants, revivals of long ago, which have been submerged but which now reappear due to our reversionary tendencies—uprooted by dissociation, disintegration or regression, with its lapse or descent to low cultural or psychic levels—these old components which reappear or rather fall apart and appear as independent activities, are exaggerated, inflated, caricatured or excessively performed. In our devolutionary tendency toward ancestral methods of reaction, the individual, resolved, so to speak, into his proximate elements, permits or is compelled by biological determinism to permit these split off tendencies to break forth once more, albeit in exaggerated fashion, as if let loose from the leash of control by the higher nervous centres, and reanimified, intensified, and magnified, our infantile, archaic, instinctive, inherited, hidden, phylogenetic tendencies or activities held sway.

It seems to me that it is well worth while to quote at some length from G. Stanley Hall, that great exponent of genetic psychology and all that it stands for. His very stimulating and inspiring paper on fear, to which I have already referred, is freely quoted in the following paragraphs.

According to geneticism, Stanley Hall tells us, all responses to shock are vestiges of once useful reactions. In fact, the shock neuroses and shock psychoses, if analyzable psychogenetically, "would be found to be reversions to, and also perhaps more often than we suspect, magnifications of acts and psychic states that were at one time the fittest of which our forebears were capable.[9] However, all the pathological phenomena of today are not mere revivals of the acts and states of primitive man and his ancestors, but "they are often, on the other hand, grotesque variants and intensifications of phylogenetic originals that were more sane and simple if also more generic. Shock symptoms may thus be symbols of long past racial experiences which when we have learned to interpret them more fully will tell us much of the early history of our phylum."[10] It is the outbreaks of emotion which "mark the incursions of the race into the narrow life of the individual."[11]

[9] Loc. cit., pp. 178-179.

[10] Loc. cit., p. 179.

[11] Loc. cit., p. 183.

Furthermore, "the central nervous system differs from all others in that it is par excellence the organ of registration and of physiological memory. It is there that the traces of ancestral experience are stored so that almost nothing that was ever essential in the development of the phylum is ever entirely lost. Hence suggestive as are many physical traits of our racial history, the intangible psychophysic traits must be assumed to be both far more numerous and more indelible.

"While these faint tendencies often crop out in a behavioristic way, by far the most of them need some stimulus of individual experiences to awaken them, and still more exist only in the slight facilitization of impulses or permeability of nervous centres, lability of molecular or neural tensions, or as preferential re-enforcements, in one rather than in another direction or manner."[12]

[12] Loc. cit., p. 351-352.

It is obvious that motor expressions of shock or motor methods of adaptation or reaction are much older and far more prominent than psychic. But although a changed environment made the old types of defense obsolete, they still persist, "in a sthenic if somewhat now inco-ordinated way, and when they are called into action now they evoke a faint phosphorescence of the old primordial feeling."[13]

[13] Loc. cit., p. 197.

In brief it should be said that no matter how refined and how highly cultured we are, we still fear and react to emotions "in the same terms of the same old gross organs and functions as do the brutes."[14]

[14] Loc. cit., p. 197.



REGRESSION

As I have stated in a previous paper,[15] the pathogenesis of tics and allied conditions can best be appreciated by viewing the subject from an evolutionary standpoint. In our reactions and adaptations to the varying experiences with which we meet we respond by one or more of several methods of motor reaction. These motor expressions are of increasing complexity as we ascend the scale of evolution and development. One of the simplest kinds of adaptation is by simple, reflex muscular action, the response being anatomical and not physiological in its extent. Then come our simple physiological reactions. A more complex reaction is by those physiologically co-ordinated motor reactions or movements which go to comprise our pantomimic movements. This is seen most characteristically in our facial expressions, gestures, mimicry and dancing. Still higher up in the scale we find our conduct and feelings as exemplified in our speech. And finally, highest of all, we must place our conduct as shown in written or printed language. This is a brief outline of our evolutionary and developmental ascent and of the increasing complexity and refinement of our social conduct.

[15] Tics. Interstate Medical Journal, January and February, 1915.

In our motor adaptations we respond in one or more of these ways. When for some reason or another one outlet us denied us, we find avenues of expression through one or more of the other paths. Now, the manner and degree of our response is dependent on our stage in evolution and development, on the development of our senses, on our instincts, feelings and emotions, on our intellect and experiences. Unable to find expression by means of writing or speech, we instinctively fall back upon and seek expression by a less refined method, one earlier acquired and thus lower in the scale of evolution. This has a more or less general application throughout the scale of human (individual and social) conduct. It is an application of the universal law of adaptation to existing conditions in the best manner possible under the circumstances. We may thus lay down in a general sort of way a conception which I like to call the theory of psychophysical progression, fixation and regression along evolutionary and developmental lines. In the case of tics the regressive or devolutionary aspect comes in for special consideration. We may react mainly physically, or mainly psychically. But as a rule we react by both physical and psychic means, the manner and degree of our conduct being determined, as above mentioned, by our stage in evolution and development.

How does all this preliminary and general discussion apply to the problem of the tics? The relation seems to me to be most intimate and most important. The tics are methods of response or reaction to certain external irritations or ideas, this response being the manner of adaptation. The response may be mainly motor or mainly psychic, most frequently psychomotor. When the source of irritation and the cause for action is known, our conduct is more specific and is apt to be less diffuse, less inadequate, less indefinite. In our reactive adaptations, which, as explained above, are greatly dependent upon our psychophysical make-up or constitution, we protect ourselves consciously or more or less unconsciously against disagreeable, inimicable, unpleasant or irritating environmental factors, physical or psychical, by bringing into activity certain psychical or physical or psychophysical reactions or processes. The special defense reactions brought into the foreground are those which follow the line of least resistance, due to hereditary or environmental construction, or are those which were most intensely stimulated or irritated and the most biologically useful and adaptive at the particular moment or under the special circumstances. The young child's reactions are preponderately motor, or at any rate psychomotor and not purely psychic. When there are sources of irritation or bodily or mental discomfort, there is a more or less general bodily reaction, psychophysical in nature. When the irritation is definite and clearly recognized by the child, the local motor response is also apt to be definite. When, on the other hand, the irritation is but vaguely perceived and not clearly appreciated or localized, we find that the child may show a general diffuse reaction, or even, in some cases, a reaction limited to certain regions as determined by the reaction taking place along the line of least resistance. This is plainly seen in the conduct of the physically sick child. Every pediatrician will find ample proof in support of this statement in his observations of the defensive reactions of the ill child.

When this irritation along a certain nerve path is oft repeated or quite constant, we have a consequent repetition of the defensive reaction, whatever it may be. This performance may be so frequently repeated that the idea of irritation or mental conflict or the anticipation or the expectation of a repetition of same may be quite sufficient in itself to arouse this reaction. It may become so habitual that, even though no such idea be in the mind, there may be a repetition of the movement whenever the individual is nervously excited or upset, whenever there is any mental stress, strain or discomfort. And we may go even further and say that as a result of some unusual mental struggle, some excessive mental strain, defense or adaptation is brought about by regression or resort to a tic, this being conditioned by the fact that for the particular individual under discussion this is the easiest, most convenient or most immediate form of reactive response. The discharge is, as is seen, along the line of least resistance. This line of least resistance is determined by the organic nervous constitution and by certain life-experiences or habit-formation factors. In some cases the movement, once initiated, may be continued long after the disappearance or cessation of the external irritation, because of the sense of relief or satisfaction or pleasure[*] which is obtained by the performance of the tic. In many instances the habit has become rather fixed, and, as a relief from the struggle to do or not to do the movement, and because of fatigue in the effort to inhibit or control the movement, the individual adopts the path of least resistance, best for immediate relief from mental struggle; and as a psychobiological effort at self-preservation and self-gratification, as immediately as possible and at any cost to be paid in the future, he gives vent, as it were, to the movement.

[*] This is not, of course, of a sexual nature the Freudian school notwithstanding.

The psychic symptoms may come on at a later date than the motor symptoms or simultaneously, although, of course, the early life history, in childhood and puberty, for example, if we are dealing with an adult, may show, at least in a certain proportion of cases, that the individual was of a psychopathic type, perhaps somewhat shut-in or asocial. If the appearance of the psychical symptoms be simultaneous with that of the physical symptoms, we can understand at once how, like the motor symptoms, they may be repeated time and again. In many instances, at least, the psychic symptoms arise later, being added to the motor symptoms. These later psychic symptoms may be a direct reaction to the source of irritation, or may be occasioned by the dissatisfaction at being unable to control the movement in question.

The degree of reaction, its duration and severity, depend upon the hereditary and developmental make-up of the individual and the severity, frequency and duration of the irritation, physical or psychical. The psychic element is particularly apt to vary. The more neuropathic and psychopathic the make-up the greater is the reaction.

Where mental enfeeblement or mental disorder exist, the severity and chronicity are apt to be still greater.

There is thus a fixation, or rather a regression or reversion, oft repeated, to a type of reaction of a very infantile, primitive sort, farther down in the scale of evolution and development.

This picture may be further complicated by so-called neurasthenic, psychasthenic, hysterical or other reactions. Naturally one would expect to find these conditions, especially the more aggravated forms, in individuals of a neuropathic and psychopathic family strain, and who themselves are neuropathic or psychopathic or both.

It may be mentioned here, as is clearly appreciated from what has been said before, that there is an interrelationship between the tics on the one hand and the symptoms which we discover in the psychoneuroses, psychoses and the mentally unstable on the other.

In all of these conditions we find a cortical origin for the disturbance, there is a lack of will power, of inhibition and of control of the lower centres, there is a nervous and mental instability with a tendency toward regression or dissociation, and the assumption of more or less independent, almost automatic activity, this activity being characterized by its almost (relatively) infantile, primitive, archaic makeup.

Were I to take up any one of the tics as an illustration, this general idea could be applied very nicely. But I shall not present any illustrative cases in this paper. I shall leave it to the reader, however, to explain the genesis and evolution of, for example, facial tics (which are so common) from this standpoint.

In passing I may say that the tic movements may have a special, individual, psychological significance. But this is by no means necessarily so. Frequently, I am inclined to believe usually, these movements result rather merely because there has been effected a psychobiological reaction, following the theory of psychophysical-progression, fixation and regression with involvement of the nervous paths most seriously affected or most easily disturbed.

In the case of the tics, therefore, it is as if the various tic movements are being used in reaction to or in adaptation to sources of internal or external, physical or mental irritation, for the protection, defense or self-preservation of this or that particular part of the nervous system—as if the movements which we find in the tics and which are the expressions of certain engrams, neurograms, mnemes or organic memories, are existing in and for themselves, except that, in the tics, they are reacting with and for the psychophysical organism, the organic make-up or personality.

The individual, as a biological unit, is reacting to the particular situation which presents itself by the tic mechanism.

By granting the phylogenetic, racial significance we also give the basic, psychophysical meaning of tics in all ticquers.



EXCITING FACTORS

How is it that these activities may come into play again? What brings them to the surface once more?

There are many factors which come in for consideration in this connection. In the first place the basic cause is the instinctive, organic, psychophysical make-up of the individual. Whether and which functions re-exist as of old and respond as means of adaptation and self-preservation, depends on the stability and the weaknesses or defects of the nervous mechanism or system with its various parts, systems, functions or inherent psychophysical dispositions on the one hand, and the life-experiences and the immediate inciting factor on the other hand.

A neuropathic or psychopathic or neuropsychopathic constitution with its usual causes (germinal, intrauterine or extrauterine, usually of a toxic, infectious or disturbed metabolic nature, and including particularly alcohol, syphilis and nutritional disorders) may form the ground work. This predisposition may be congenital—that is, present from the date of birth, although not necessarily germinal in origin, or it may be acquired at some period in life from physical or psychic causes. In this connection the infantile and early childhood history are very important. Consequently the diseases, training, example, education and opportunities in childhood and infancy are of very great significance, the parental training and example and the home conditions having a most intimate relationship to the development of many of these tics. Imitation and mimicry here play a decided role. Spoiled children, too quickly satisfied or over repressed, are apt to develop tics. External somatic irritations may be the starting point in some (not in all) cases. At other times an idea (normal or abnormal) may incite the tic movements. Auto and hetero-suggestion, hypochondriacal ideas, hysterical symptoms and obsessions may, particularly in adults, initiate tics. Obsessions are especially apt to produce habits or tics, if they produce any motor reaction. Tics may develop into obsessions and vice versa; or both may co-exist simultaneously and be unrelated. The original ideas which led to the movements vanish while the movements survive. In the insane various sorts of delusions may be the groundwork on which a tic may later develop. Habit movements, which represent purposive physiological acts which have become automatic and not inhibited (hence showing weak will power) and which seek strongly for expression, which the individual struggles against and endeavors consciously to inhibit and overcome after the tendency is fairly well developed, may eventually become impulsive and irresistible with the ultimate evolution of the psychic state which is characteristic of ticquers. Automatic habits and mannerisms or stereotyped acts are of course not tics but the latter are but caricatures of the former with an added characteristic mental state. Tics, as mentioned earlier in this paper, are thus pathological habits.

Tics may also be but the symbol for a vague feeling of tension, irritation or stimulation, which seeks relief or expression by the performance of the tic.

Emotional stress and strain, fright, fear, excitement and mental shock can arouse a tic. Mental conflict and unrest has not received that degree of attention which it surely deserves. Clark and the Freudian school have definitely called our attention to this aspect. Bresler refers to tic as a motor reaction to original mental shock, so that it is in fact a psychic defense reaction of expression. Dupre has stated that emotional shock may act as a possible exciting cause of tics, as at times of obsessions. Meige and Feindel have asserted that fear may excite a movement of defense, and although the exciting cause has vanished, this movement may continue to persist as a tic. They also mention that in ticquers we frequently find the impulse to seek a sensation and to repeat to excess a functional act.

That there is a weakness of will power in the ticquer, with a lack of control or inhibition over the lower neurones normally regulated by the higher co-ordinating centres, so that certain automatic activities become dissociated and exist more or less independently, is generally acknowledged.

In fact it must be said that tics are reactions of the organism, of the organic make-up, the psychophysical personality, as a response to irritation, excitation or stimulation, sensory, nervous or psychic! It is a means of relief of tension, of organic reaction or adaptation, not necessarily conscious but frequently unconscious and automatic, as in fear. Starting in this way it may persist. In the tic we see a method by which the individual or organic personality has met a certain difficult or undesirable or disturbing situation. It is thus a constitutional, biological defense reaction, psychophysical in nature, with a reversionary tendency (when viewed from the evolutionary standpoint), and hence is indicative of degeneration, this term being used in the racial, biological, phylogenetic and ontogenetic sense.

There is not such a far cry from the simplest tic to Gilles de la Tourette's disease or maladie des tics with its more pronounced signs of psychophysical deterioration and dissociation. The tendency is a degenerative one— a prolapse to ancestral methods of reaction, a dissociation or disintegration of the personality, a lack of control over more elementary activities. We should therefore appreciate the need of early recognition and treatment of tics and fixed habit movements, especially since there is a tendency to spread, for the tics to multiply, and for mental symptoms and reactions of a hysterical and psychasthenic nature to appear, if they do not already exist or have not existed before the onset of the tic.

In brief, then, tics represent the emotional reactions and feelings of the individual—the loves and the hates, the likes and the dislikes, the wishes and the fears, the cravings and the dissatisfactions, the bodily and mental tension, unrest, excitement, discomfort and disequilibration. In other words the ticquer feels and speaks and acts by the tic. He lives by, in and for his tic. He is attempting to meet certain situations of a disturbing nature and to obtain equilibrium and equipoise by compensating for his feelings of inefficiency and unrest by the tics. It is an organic, constitutional, psychophysical, biological means of adaptation.



PROGRESSIVE EVOLUTION OF THE CONDITION

We now come to the progressive evolution of the motor manifestations and to the mental aspect of this condition.

Concerning the mental state characteristic of the ticquer it is generally agreed that there is a polymorphic psychic defect or disorder which shows itself particularly in a precocious or hyperemotional condition, in a lack of will power and of inhibitory control, leading to a state and feeling of doubt, indecision, incapacity, insufficiency and unreality, of inferiority and self-depreciation, with a tendency towards morbid self-absorption, egocentricity, self-observation, auto-and hetero-suggestion, with the consequent development in many instances of so-called neurasthenic, psychasthenic, hysteric and various psychotic reactions. I am not prepared to say definitely how frequently the mental state, in lessened degree, precedes the outbreak of the tic movements. This may be present in a certain proportion of cases, but is by no means always present and it is even questionable whether the predispositional mental condition is the ground work in the majority of patients.

Tics, it is true, are especially apt to develop in individuals with a neuropathic or psychopathic history or heredity. In other cases this history is not obtainable, the individual having been apparently perfectly normal up to the time of the outcropping of the tic. In these cases shock is apt to bring on the outbreaks and so one may say that the instability had been latent and that a severe shock was sufficient to bring it to the surface. We must remember, in all these cases, that the mental state which we see in the ticquer is but an exaggeration of that which appears in many children, and is similar to that which appears also in other psychoneurotic states, and in fact the germs of this condition may occur transiently in any of us. This psychic condition may frequently but does not always precede the appearance of the tic movement. But it is only after the appearance of the motor manifestations of tic that the mental state becomes prominent or develops where it was not noticeable if not absent before.

Be that as it may, or even granting that in most patients the characteristic mental state or the neuropathic or psychopathic make-up exists in some measure to an abnormal extent, we do know that once the tic movements have made their appearance and begin to spread, so that the individual is thrown into the struggle to perform or not to perform the movement, the development of the psychic state which we find so patent in the more pronounced forms of tic, thereafter more or less rapidly occurs, no matter what the mental condition of the ticquer may have been previously. I am also not prepared to discuss here at any length the phylogenetic or ontogenetic significance and the biological genesis and meaning of the various mental trends of the ticquer, but I may say that they too have been acquired in the course of evolution, for certain very definite reasons which need not concern us here, although it can be appreciated that the biological motive of self-preservation played a most important role in their genesis and fixation.



APPLICATION OF ADLER'S THEORY OF THE NEUROTIC TO TICS

The progressive spreading of the tic movement which so commonly occurs, as well as the evolution of the mental aspect which develops subsequent to the appearance of the tic movement, may be very nicely understood if we adopt, for our present purposes the recent theories of Alfred Adler,[16] of Vienna, concerning the makeup and development of the neurotic. This we may do without committing ourselves, at this moment, one way or the other, with regard to the correctness or incorrectness of Adler's views as applied in toto to the neurotic.

[16] Ueber den Nervosen Charakter, 1912. See also Adler's Studie uber Minderwertigkeit von Organen, 1907.

One should note that Meige and Feindel were, in a way, on the threshold of this theory when they said that tic, like the other psychoneuroses, is due to some congenital anomaly, an arrest or defect in the development of cortical or subcortical association paths—unrecognized teratological malformations.

In a very few words Adler's theory may be given as follows: Adler assumes that there is definite somatic inferiority (based on anatomical and physiological changes) as the basis or foundation for the neurotic soil. The neurotic consciously comes to realize the unconscious, organic, somatic inferiority, and the endeavor to effect a psychic compensation or to make up for these organic deficiencies by certain definite mechanisms, frequently results in an overreaction or over-compensation. He thus overdoes himself in efforts to make up for his inferiority, and in these endeavors he necessarily makes use of unusual means and devices. It is this effort which is the great motive force which dominates the life activities of the individual and which compels him to seek as his ultimate object or final goal a state which is best described as one of complete masculinity, of full manhood, of self-maximization, of the will to live, to become powerful and to seek supremacy or "the will to power" (Nietzsche). In following this goal he goes to extremes and employs peculiar methods and devices, most of which have for their object the concealment of his defects, and it is these overcompensatory efforts and these peculiar devices resorted to, which go to form the peculiarities or traits of the neurotic. According to Adler's theory, the conscious efforts of the individual for psychic compensation or overcompensation (for the unconscious, organic deficiencies) leads to a resulting feeling of insufficiency, of incompleteness, of inferiority, of unreality, of anxiety, of inability to face reality. Thus the mental symptoms or characteristic mental state, being but the conscious recognition of the unconscious inferiority, become especially pronounced when there is a failure of compensation, or, in other words, when the individual is unable to meet with or adapt to the situation which at the moment presents itself. In these forced efforts at defense and compensation there is a resort or regression to older, infantile, child-like, archaic types of reaction, of a physical or mental nature, which are thus the protective defense mechanisms or symbols. The struggle of the neurotic consists particularly in the conscious appreciation of his goal and of his deficiencies of makeup and in the attempt to reach his goal of full manhood and self-maximization in spite of his handicapping deficiencies.

Without discussing the exact status of this theory in the case of the psychoneuroses and their related conditions in general, we may, as mentioned previously, very conveniently use this theory in the elucidation and understanding of the further development of the tic condition.

Let us first consider the spreading of the tic movements. We know how in the ticquer one tic movement may disappear only to give way to another, or one after the other an increased number of tic movements and also of definite compensatory movements not of a tic nature but of the nature of antagonistic gestures and stratagems may make their appearance. The latter may in certain instances become habit movements and eventually real tic movements. One movement after the other may be resorted to, some perfectly consciously, others more or less unconsciously, as reactions of the personality, of the organic makeup or psychophysical constitution. These movements are adopted by the patient, frequently more or less unconsciously, in order to attain a state of equilibrium and rest, and in order to hide and make up for the defect (the tic movements) of which he is aware. In these efforts he overdoes himself and instead of hiding the movement he exaggerates it and even resorts to further movements in his struggles to compensate, to adapt, to conceal, and to flee from a state of mental disarrangement to a state of psychophysical equilibrium.

Now, most of our gross reactions are of a psychophysical nature, so that we find that when the old types of defense or of activity are called forth (as they are in the tics, as explained earlier in this paper, from the evolutionary and phylogenetic standpoint), the resulting actions, now reanimified, appear in exaggerated form, and also tend to "evoke a faint phosphorescence of the old primordial feeling." This probably results in the outcropping of the various psychic trends which appear in the ticquer and which increase in degree and in number. The most common of the resurrected psychic trends is the general tendency to dissociation or disruption of the personality with the reanimification, in varying degrees, of certain mental deficiencies and inferior types of reaction which are indicative of the relative failure of the patient to measure up to and efficiently deal with and adapt to the struggles of life as he must face and meet them. And so, many undesirable and inferior kinds of mental trends come forth and hold sway. The basis of their appearance is the lack of will power and of control over these various trends which were previously more or less completely held under control but which are now impulsively forcing their way to the surface and being unravelled. These trends are characterized by their relative immaturity, their infantile-like and archaic type. And so we have the states of indecision, of doubt, of uncertainty, of inferiority, of depression, of unrest, of self-depreciation, of self-observation, of auto and heterosuggestion, of egocentricity, of self-criticism, of inhibition of the expression of the personality along the broader, social lines of effort. The groundwork for added states (hysteric, psychasthenic, and others) is here very fertile.

The law of psychic ambivalence and ambitendency, as so nicely developed by Bleuler,[17] here shows itself in marked degree. There is both the positive and the negative tendency toward the performance and execution of these activities and reactions which are necessary for the living of a life of a high or low degree of efficiency, so that the ticquer is obsessed by the problem of "to do or not to do." This added factor leads to an exaggeration of all the unfavorable psychic tendencies which have made their appearance, and the intrapsychic struggle goes on with increased vigor.

[17] The Theory of Schizophrenic Negativism. Translated by William A. White. Nervous and Mental Disease. Monograph Series, No. II.

The entire mental picture which we find in the most extreme forms of tic could be beautifully elaborated along these general lines. For example, the ticquer becomes asocial, seclusive and shuns society because of the consciousness of the condition and the exaggerated sensitiveness. This represents compensatory, defensive methods of concealment. Absentmindedness and the inability to concentrate the attention are conditioned by the great degree of attention devoted to the tic. The mental dissociation or disintegration leads to an inflating of the emotional aspect of the patient's mental life with a resulting increased nervous irritability and reaction and a heightened degree of susceptibility to emotional disequilibration and fatiguability of the mental faculties. The lack of self-assertion, of confidence in himself, and the feeling of inferiority and insufficiency are natural consequences of the general picture. The inhibition of even, unhampered self-expression is always observed.

In tics, it must be noted, there is regression to more inefficient and inferior methods of response and adaptation, the types of activity being of a somatic and psychic nature. Following the regression and owing to constant repetition and habit formation there is a gradual fixation to certain methods of response which become the lines of least resistance and this is followed by progression and development of the general picture to other tics and psychic symptoms.

In general we note that the psychophysical reaction which we come upon in the tics leads to the unearthing of various psychophysical types of reaction, this unearthing consisting of disintegration or regression or dissociation, the repressed, hidden, unconscious, phylo and ontogenetic, archaic and relatively infantile-like activities, tendencies and possibilities coming to the fore and unfolding themselves.

It is here seen that this broad genetic standpoint is one of the greatest contributions to psychopathology and is of infinite aid to us in the understanding of the problems which confront us in the domain of psychopathology and psychiatry.

Comparative and animal psychology and the study of the reactions of children, of primitive races, and of the mentally disordered give us a splendid opportunity for studying it and unravelling the meaning of the many somatic and psychic manifestations which are exhibited to us in the psychoneuroses and psychoses and in tracing out the racial history of man. Is it not plain that an understanding of the genesis and meaning of tics opens the gateway to the elucidation of the origin and significance of the psychoneuroses and functional psychoses—of reaction types of various kinds?



REVIEWS

THE INDIVIDUAL DELINQUENT. By William Healy, A. B., M. D. (Little, Brown & Co., Boston, 1915.)

It is a rare and pleasant experience to meet a book on such a general topic as delinquency, which has not as its raison d'etre the exploitation of some over-worked hypothesis. The Director of the Psychopathic Institute of the Juvenile Court in Chicago has, however, not only avoided this danger but has given psychologists, jurists, and penologists such a report of his five years work as not one of them can afford to overlook. As the title of the work implies, the material is drawn from the individual study of the delinquent. He presents the results of the unbiased investigation of the discoverable factors in the production of criminality in 1000 recidivists, who were mostly, though far from exclusively, adolescents— the period when factors, both internal and external, are most easily determined and modified.

A careful perusal of the introductory chapter on methods reveals both the thoroughness and open-mindedness of the author. He demonstrates that no satisfaction was gained by the finding of any special mental or physical abnormality, unless a more direct relation could be shown with the crime committed than is established by mere coincidence. It is particularly satisfying to note the precautions taken in the application of set tests, how careful Dr. Healy and his assistants have been to determine the completeness of cooperation on the part of the subject and to weigh this factor in evaluating the results. One soon reaches the conclusion that the author's own series of tests are much more likely to lead to reliable diagnosis than the series of Binet, which demands so much of the rather specialized capacity of abstract formulation. Healy's tests, on the other hand, deal fairly with the primitive, untaught mind and that which has an unequal and deceptive development of language ability. In connection with these tests, it is interesting to note, by the way, that he finds irregularity in results (or cooperation) to be so often associated with epilepsy and depletion from sex over-indulgence that it may be taken as a suggestive diagnostic feature.

The value for the reader in discovering the eclectic view-point and critical conservatism of an investigator lies in the confidence which these qualities beget in the reliability of results. One can read most of "The Individual Delinquent" to learn facts without the distraction of critical uncertainty. With this in mind, therefore, a few of his conclusions, picked mostly at random, may be quoted. An important factor in the production of delinquency he finds to lie in the premature appearance of adult sex development—a precocity which he regards as dangerous because it seems to be correlated with a stimulation of sex instinct before adult inhibitions appear. In girls (not in boys) he finds a distinct tendency to general physical over-development as compared with the norm of the same age. In this connection it is striking to find how many of his cases, which seem to exhibit ingrained criminal tendencies, are delinquents only during the period of adolescent instability. The various statistics are naturally also of extreme interest, particularly since they are the result of examination of 1,000 cases, chosen for this purpose only when there were sufficient data secured to make the individual study relatively complete, and since they are so at variance with the publications of others who have approached criminal statistics to prove a theory rather than to learn facts. He finds alcoholism in one or both parents in 311 cases. He cannot determine any direct inheritance of criminal tendencies as such, but regards them as indirectly of great importance as there were 61% who showed distinct defects in the family antecedents. He thinks that stigmata of degeneration are probably better correlated with mental defect and also with nutritional or environmental conditions than with criminalism as such. Followers of Lombroso will be disappointed to read that he found only 83 epileptics, or possible epileptics, among his 1,000 cases. A full two-thirds of the cases presented no symptoms of mental abnormality while only one tenth were definitely feeble-minded. These are but scattered data; no digest, which might be taken as substitute for the book itself, would be advisable.

It is to be expected, of course, that psychologists (and particularly those interested in dynamic psychology) will find mixed pleasure in reading this work. The section on "Mental Conflicts" must appeal to all with its practical demonstration of what can be done by psychological analysis to abolish anti-social tendencies in many puzzling cases. There will undoubtedly be disappointment in his failure to make general psychological formulations, but, as the critics would differ amongst themselves as to what these formulations should be, Dr. Healy's silence is here probably a wise conservatism. At the same time there is certainly exhibited a tendency to be rather too individual and give too few generalizations. This is evidenced by his failure to regard as a factor in one case what has been admitted as such in a slightly more obvious instance. To cite one example: On page 192, he speaks of the inheritance of hypersexual tendencies; on page 166, we find: ". . . immodest behavior and use of obscene language on the part of a parent, which we have so frequently found to be one of the main causes of a girl going wrong . . . " Somewhat similar results are thus ascribed once to heredity and again to environment. At this stage of our knowledge it would, of course, be foolish to eliminate any specific inheritance as a factor, but it is surprising that in the former case he does not consider environment as a factor, although he elsewhere gives striking evidence of unconscious influence proceeding from one individual to another via sex initiation.

It is possible that this lack of a broad psychological view point— this example chosen is far from isolated—is connected with a specific, and most definitely serious, defect in the book. The treatment of the psychoses is distinctly unsatisfactory. Apparently the author has had to rely on the literature for his preparatory experience and has been fortunate only in some cases, if we may judge by his references. The most satisfactory group he describes is that of the traumatic psychoses and there he follows Meyer's admirable study. On the other hand, in introducing the Dementia praecox group, he makes no specific mention of any one of the cardinal symptoms of disassociation or shallowness of affect, scattering of thought, and delusions or hallucinations. His nearest approach is when he says: "Variations in the way of excitement, with dullness and paranoidal excitement are seen during the course of the disease." This is followed by the description of a case which he says contains the symptoms typical of the psychosis but in which no pathognomic abnormality is mentioned except negativism— a vague term whose meaning varies with the observer.

Not unnaturally with such unfamiliarity, the psychosis is a "dispensation of Providence." There is no evidence that to him psychiatry is as much a problem of every day life as it is of institutional care of the insane. We can, therefore, find such a statement as this:

"The mental findings and the conduct determined the fact of aberration and that is all that should be necessary for immediate court purposes. Further business of diagnosis should be left to a psychopathic hospital."

It is true that responsibility may and should be evaded when the psychosis is full-blown; but how about the innumerable cases of incipient psychotic disturbance which grade over into the "mental conflicts?"

In harmony with this diffidence is the repeated hope for aid from the Abderhalden. or some similar reaction. For instance:

"The newer methods of diagnosis of Dementia praecox we look forward to for help in one place where discrimination is important."

But surely a psychologist cannot hope to predict conduct by physical findings! If Dementia praecox postulated criminality, the situation might be different, but, as it stands, the reaction would only be of value in the doubtful cases— cases which are so many of them non-institutional.

With this vague conception of the psychoses it is not surprising to find that diagnosis used faute de mieux. For instance, in describing Case 169, of "pathological lying," he says:

"We could not in any way find evidence of mental peculiarity but we did question his story because of intrinsic improbability." Rather conflicting statements! Later on, he explains, the case was diagnosed as one of "epileptic psychosis" because the subject developed convulsions, although there is no evidence, or even claim, presented that the lying was an equivalent, or in any way correlated with the epilepsy except as a coincidence!

Such faults in a book of this sort are serious but only in so far as the work is theoretical. The main object of the book is to present facts in an unbiased way and for the first time we have them in anything like completeness. The importance of Dr. Healy's labors cannot, then, be overestimated. His publication will be eagerly welcomed by the army of workers who see a few cases at various stages of delinquency and who long to know authoritatively what the types are, how they develop, what the outlook is, and how that may be modified by appropriate treatment. We owe him much. JOHN T. MACCURDY.



HUMAN MOTIVES. By James Jackson Putnam, M. D. Professor Emeritus, Diseases of the Nervous System, Harvard University. Boston. Little, Brown & Co., 1915; 12mo. Price $1.

According to the publishers' announcement this is a study in the psychology and philosophy of human conduct, based largely on the author's use of the Freudian psychoanalytic method of mental diagnosis. The editorial introduction by Dr. Bruce consists in a brief outline of the subconscious mind. The author's preface, aside from anticipating the main features of the book, makes the announcement that the latter is based very largely on the personal experience of the last two years. The author gives one the impression that this period represents to him one in which he has to his own satisfaction mastered the relationship between psychoanalysis on the one hand and our current conception of moral philosophy, ethics and religion on the other. During this period he has "studied motives at close range."

The work consists of six chapters and of these the first two deal with the philosophic method of viewing man, while the others are devoted to psychoanalysis. In the last chapter the author makes suggestions as to the possibility of synthesizing the two methods.

Human motives are either constructive or adaptive. The former are associated with conscious reasoning and will, the latter with emotional repressions. The former represent aspirations and are much higher than they seem, since every man has an ideal—"getting out the best that is in himself." He is a "lover of the best" and will die for and live for mere ideas and abstractions like patriotism. He is assumed to be free because he voluntarily creates, and is as free as anything in the Universe; and he is free because he can choose. But where there is freedom there must be clashing and compromise and repression. Among repressed subjects are prejudices and superstitions, which, while irrational, unconsciously affect our conscious motives.

Man has feelings of humanity and brotherhood but has also the feeling of separate individuality which comes from the egoism of the young child. The instincts also come into play in the conflict between duty to others and love of self. No one, however good, can escape this conflict.

The old teaching as exemplified in philosophy and religion is based on a study of man at his best, man in the abstract. This is incomplete because it cannot promote such feelings as sympathy and understanding among men. Something has always been needed to supplement it and this is found in psychoanalysis in which conditions are reversed.

Religion the author regards as an existence which is in harmony with that of the "universe-personality." If we have the attributes we give to the Deity as reason, love (disinterested) and will, we should seek this harmony. The "world of sense" is antagonistic to this conception, in that it leads us to reject all other than sense knowledge. Our notions of love, honor, power, justice cannot spring from the sense-world. We must look beyond the latter—a mere illusion—to find the true, immutable. Mind cannot be evolved from life but must pre-exist. God and man must be conceived in the same way—both represent a totality of expressions of world will, both create and persist in their creations. Man must be regarded as creating his thoughts and acts, even his own body. Every portion of the universe is responsible for every other portion. Man, though ever changing, represents a "self consciously unified person" and therefore feels responsible for all he has ever done or ever will do. Freud himself, as the author states, never cared to generalize on the subject of psychoanalysis.

The book proceeds with a general outline of psychoanalysis which need not be reproduced here. The subject of sexual repression, so far from being exaggerated by Freud, is completely borne out by centuries of teaching by the Church that all sexual matters must be repressed, because they proceed solely from the flesh, the material world. As we have seen, however, the author with others—both Freudians and non-Freudians—makes the libido a form of creative energy, which attitude lifts it above the purely material plane. Complete suppression of anything which will not down is regarded as unwise hygiene of the soul, and the results of psychoanalysis, both as to cause and cure of neurotic disturbances, amply sustain this view. A man's unbidden thoughts are part of him and must be acknowledged.

Psychoanalysis cannot be employed upon a number of subjects at once. It lies between physician and patient, teacher and pupil. The unconscious but active motive must be brought under the conscious will. The fantastic world of childhood must be re-created. The teacher, dealing with childhood has an advantage over the physician who applies his analysis to adults.

The child should be encouraged to show all that is in him, and at the same time must learn to regard himself less as an individual and more as a social unit. He should do things which divert him from himself.

In psychoanalysis an act is nothing, a tendency everything. The latter must be changed. In analysis of one's self one must avoid all tendency to self depreciation, since all must make mistakes. One should also distrust in himself whatever savors of emotional excess.

There is no radical difference between the neurotic and sound subject in respect to the presence of unreasonable fears, compulsions and obsessions. Stress of circumstances causes even the normal man to show objectionable traits. Mental disease-phenomena, like physical, indicate natural reactions, or "attempts at repair" such as are found in the organic and even inorganic worlds.

Treatment by psychoanalysis represents an education—the removal of inhibitions which are fixations or arrests.

The fifth chapter is in a way a resume of what the author had previously said. He also seeks to reduce his teachings to a tabulation. The rationalisation or adaptation of life progresses in proportion as the individual is mature, but here maturity is by no means equivalent to age. The process also is active in the immature child.

A subject is usually quite unaware of his fixations and explains the results of his internal conflicts by false reasoning. Rationalisation in this connection becomes a bad habit.

All motives are creative. The act is not the result of the immediate motive but of all those which preceded it. The final act throws no light on the original motives.

In speaking of certain adults as children who never grew up, we are referring to a much larger class than is commonly understood. All who attain mature years with fixations are to be regarded as children. All individualists belong here unless their individualism is merely a stepping stone to altruism. Indeed, we see in all men a desire to place themselves on a pinnacle. This craving seeks expression in a thousand acts. Even if outgrown it may assert itself in times of stress. It is of benefit at times when individuals espouse just but unpopular causes. What we ordinarily call courage involves self assertion but a higher courage is involved in refraining from certain things.

All individuals also have occasional cravings to get away from responsibility and back to rest and pleasure. We long to get back to a theoretical state of childhood, as the infant longs to return to his mother's body.

For a number of reasons this not a work to be criticized. The author does not mean to be dogmatic. His dicta, while they may have the ipse dixit flavor, are not meant to be axioms. The creative energy of the mind can formulate these dicta and they must clash with the convictions of others. It is easy to deride the method as a method, but we must judge it by its results. In Emerson's hands it became a profound stimulus to thought to people of quite dissimilar mental makeup. In like manner the author's work will prove of the highest suggestive value to the reader, and especially the materialistic reader. But aside from the general character of the book we must not forget that it has a very definite object, to wit, to elevate psychoanalysis to the highest planes of philosophical speculation and to remove the prejudices of those who profess to go to the other extreme and see in it only the slime of the pit. The author's attempt to bring it in unison with the eternal verities is deserving of the highest commendation and illustrates his deep faith in the nobility of this new resource for understanding the spiritual side of man. L. PIERCE CLARK, M. D.



EDUCATIONAL PSYCHOLOGY: VOL. I, THE ORIGINAL NATURE OF MAN VOL. II, THE PSYCHOLOGY OF LEARNING. By Edward L. Thorndike. Published by Teachers College, Columbia University, New York, 1913.

In the first three chapters of Vol. I Professor Thorndike introduces what he calls the 'original tendencies' of man. These are the simpler and what have often been called the 'instinctive', or 'innate' forms of behaviour. And they are here taken as innate, in contradistinction to learned; as the inherited dispositions on which the character of the adult is built. In Chapters IV to X, inclusive, these original tendencies are enumerated and described. This is a valuable, although somewhat unordered, inventory of the more elementary human activities. A wholesome step is taken in replacing the terms 'pleasure' and 'pain' (subjective categories supposed from time immemorial to account for many sorts of reaction and to be the basis of the learning process) by the more objective terms 'satisfiers' and 'annoyers'. The author inclines away from the common idea that very young individuals exhibit random or diffuse activities

A curiously baffling and admirably sceptical chapter on the Emotions (XI) is followed by a largely destructive chapter on Consciousness, Learning, and Remembering, in which Prof. Thorndike is in point of literary style almost at his worst; and in some cases incoherent (e.g. p. 185, middle). The chapters on the Anatomy and Physiology, on the Source, on the Order and Dates of Appearance and Disappearance, and on the Value and Use of Original Tendencies seem to the reviewer inconclusive and uninspired. There are shrewd and interesting remarks here and there, particularly those of a destructive intent, which the older reader will appreciate; while on the whole he will wonder whether the author has, in these last four chapters, any other than the whimsical aim of producing bedlam in the minds of his younger readers.

Vol. II is a long treatise of 452 pages on the faculty of Learning. The author would probably reject the suggestion that he is dealing with his subject in the spirit of the faculty psychology. Learning, he would say, is an empirical fact, which he is simply describing. So also, however, the 'faculties' are empirical phenomena—attention, memory, and all the rest. The question is, do Prof. Thorndike and others like minded analyze the phenomena in a way that reveals their mechanism, or in the unfruitful manner of the faculty psychology? Is, for instance, the mind an aggregate of the following "functions that have been, or might be, studied:—Ability to spell cat, ability to spell, knowledge that Rt 289 equals 17, ability to read English, knowledge of telegraphy,. . . . ability to give the opposites of good, up, day, and night, . . . . fear and avoidance of snakes, misery at being scorned," etc., etc. (p. 59)? To the reviewer it appears that these 'functions' are cross-sections of the mental life which reveal NOTHING of the mind's real mechanism. This way, surely, lie the maximum of pedantry and the minimum of scientific insight. The volume as a whole may be recommended to those who wish to ascertain to what extent academic psychology of to-day is still dominated by the spirit of faculty psychology. E. B. HOLT.



SLEEP AND SLEEPLESSNESS. By H. Addington Bruce. Little, Brown & Co. Boston, 1915. Pp. vii, 219.

This book constitutes the third volume of the "Mind and Health" Series. In it the author has given an admirable and clear summary of the recent psycho-pathological work on sleep and sleeplessness. He begins by a discussion of the nature of sleep and considering the difficulties involved in making such a discussion clear to the average reader, the author has done remarkably well in summarizing the technical work along this line. He then passes to the problem of dreams and the part played by the unconscious mechanism involved in dreaming, laying particular and justifiable stress upon the point, that when problems are solved or adjusted in dreams, they have always been previously solved by a kind of unconscious incubation during the waking moments. The chapters on the disorders of sleep and the causes of sleeplessness are brief but comprehensive, while in the discussion of sleeplessness important stress is laid on the mental elements involved in every case of insomnia. A strong plea is made for the psycho-therapeutic rather than the pharmacologica, treatment of the disorders of sleep. On the whole the book is clearly written and can be recommended to those who wish a brief and at the same time comprehensive account of the modern theories of sleep and its disorders. ISADOR H. CORIAT.



A CORRECTION. To the Editor of the Journal of Abnormal Psychology.

I wish to call your attention to the fact that the quotation attributed to me on p. 135 in the June-July issue of your Journal is a misrepresentation of what I actually said. Due to an oversight on the part of the publishers of the A. M. A. Journal, the stenographer's notes of the A. M. A. meeting were not submitted to the members of the Section for examination and correction. The Editor of the A. M. A Journal regretted this fact and the discussion of my paper "The Conception of Homosexuality," from which this quotation was taken, was published in corrected form in the Transactions of the Section of Nervous and Mental Diseases (1913) of the A. M. A. A. A. BRILL



BOOKS RECEIVED

PATHOLOGICAL LYING, ACCUSATION AND SWINDLING. By William Healy and Mary Tenney Healy. Pp. 278 Plus x and Indexes. Little, Brown & Co., 1915.

THE CRIMINAL IMBECILE. By Henry Herbert Goddard. Pp. 154 Plus vii & Index. The MacMillan Co., 1915. $1.50.

CHARACTER AND TEMPERAMENT. By Joseph Jastrow. Pp. 596 Plus xviii. D. Appleton & Co., 1915. $2.50 net.

A SURGEON'S PHILOSOPHY. By Robert T. Morris, M. D. Pp. 575 Doubleday, Page & Co. $2.00 net.

BACKWARD CHILDREN. By Arthur Holmes. Pp. 247. Bobbs, Merrill. $1.00 net.

A MECHANISTIC VIEW OF WAR AND PEACE. By George W. Crile. Pp. 105 Plus xii. The MacMillan Co. $1.25.



THE JOURNAL OF ABNORMAL PSYCHOLOGY

SCIENTIFIC METHOD IN THE INTERPRETATION OF DREAMS[*]

WITH A THEORY TO EXPLAIN THE DREAM-PROCESS AS APPERCEPTIVE TRIAL-AND-ERROR.

[*] A paper read at Columbia University, April 19, 1915, at a Joint Meeting of the New York Branch of the American Psychological Association and the New York Academy of Sciences, Section of Anthropology and Psychology.

Copyright 1916, by Richard G. Badger. All Rights Reserved.

LYDIARD H. HORTON

HISTORICALLY speaking, dreams have always been credited with meanings; but, in a given case, the psychologist must ask, how far does the accredited meaning represent the mere fancy of the interpreted and how far does it mirror actual conditions in the dreamer's mind. To seek aught beyond these is but idle divination. For of all dreams it is true, in the words of Ralph Waldo Emerson, "that the reason for them is always latent in the individual." "Things are significant enough, Heaven knows;" he exclaims, "but the seer of the sign,—where is he?"[1]

Not till the last year of the nineteenth century, did an answer come; it was Sigmund Freud's work, "The Interpretation of Dreams," which said, in effect, "Here am I, in Vienna."[2]



THE FREUDIAN PRETENSIONS

"In the following pages," he begins, "I shall prove that there exists a psychological technique by which dreams may be interpreted and that upon the application of this method every dream will show itself to be a senseful psychological structure which may be introduced into an assignable place in the psychic activities of the waking state."

The sweeping character of this pretension has not been justified. The demonstration has succeeded only with that large class of dreams in which there happens to be a trend of infantile reminiscence and of disguised sexual phantasy. It fails to reveal the inner nature of other kinds of dreams or the modus operandi of dreaming as a process of thinking. And while it is asserted by the publishers of the English[3] edition that the main contentions of his book have never been refuted, the fact is that his thesis has not been accepted by the representatives of scientific psychology, as a solution of the problem.

The exponents of Freudian interpretations today are medical men associated with the practice of so-called "Psychoanalysis;" which means that they are more concerned to apply Freud's ideas for the treatment of nervous ailments than to cultivate pure psychology. An examination of the methods they exemplify in individual practice and in the large literature of the psycho-analytic movement shows sufficient reason, in my view, why the psycho-analytic theory of dreams should still be greeted with skepticism. Psycho-analysts tell us that repugnance for the subject-matter has delayed acceptance of their essentially sexual interpretations. But there is also a resistance based on sound logical criticism. Judged by this standard, Freud's theory appears dangerously inaccurate and needs revision.



THE TWO SCHOOLS OF PSYCHO-ANALYSIS

Dr. C. G. Jung, formerly a pupil and literal follower of Freud, is attempting to reform psycho-analytic doctrine from within the fold.[4] Incidentally, he tells us that there is nothing essentially novel about the technique of investigating the dream in Psycho-analysis. It copies the methods of historical and literary criticism and consists in collecting all the data possible about each item of the dream. These are then called the dream material. What seems to me novel and characteristic is the psycho-analytic method of working up this material into an interpretation by a process of inference. Freud and Jung are today no longer in agreement as to the details of this process.[6] Speaking of the interpretations of these authorities, on the basis of extended investigations of dreams on my own part, I must say that their methods do not seem to be as rigorous, as is required today in the investigation of literary and historical problems, nor capable of bearing comparison with experimental psychology.

It must be acknowledged, however, that Freud has infinitely refined the guesses of earlier generations of thinkers as to the relationship of sleep-fancies to the waking life. He has conferred startling precision upon the general proposition of Goethe "that these whimsical pictures, inasmuch as they originate from us, may well have an analogy with our whole life and fate." And he has certainly vindicated in practice that dictum of Emerson: "A skilful man reads dreams for his self-knowledge."[1] But he has formulated no open-sesame, as psycho-analysts proclaim.

When it comes to the use of symbols, the Viennese professor parts company with the Concord philosopher. The latter, as we know, decried the mystical conception of fixed symbolism in any domain. But Freud, although theoretically agreed, falls victim in practice to the fascinations of the dream-book cipher method which he has condemned. The adjective Freudian is now justly a by-word, among psychopathologists, for a stereotyped habit of reducing each item of a dream to some cryptic allusion or roundabout reference to the primitive demands of the infantile and sexual life. Freud's fertility in such interpretations has led one of our best-known experimental psychologists to say, in mingled admiration and impatience: "His utterances are those of a poet, not of a scientist."



JUNG'S COURAGEOUS RECANTATION

As spokesman of the Zurich group of psycho-analysts, Dr. Jung has lately protested against these arbitrary translations, which he calls Freud's "reductive method."[6] In formulating a more scientific method of his own, which he calls the "constructive method," Jung reveals a change of views so extensive as to suggest, on several points, almost a conversion to the ideas that Dr. Morton Prince expressed in 1910, as to the insecurity of the psycho-analytic ideas of symbolism.[7] At that time, Jung valiantly defended the Freudian preference for stereotyped meanings as against the Principian idea of highly variable meanings.[8] Now, in going to the other extreme from Freud's cipher-like method, Jung has succumbed to the attractions of that other popular method, equally decried by his former master: the symbolical method of Joseph and Daniel.[9] But at least he has bravely called in question views which he once espoused with exaggerated positiveness.

Jung's principal amendment to the Freudian dream-analysis consists in subjecting the literal implications of the established Freudian symbols, such as snakes and staircases, to a further, more allegorical mode of treatment in which the sexual meaning is greatly altered. The evidence, which Freudians continually find in dreams, for a pre-occupation concerning infantile and sexual needs[10] is explained away, as merely incidental reviewing of past experiences, in the attempt to solve problems of the future by analogy with the past. In other ways also Jung alters his views, notably by following Prince in explaining the dream on a broad biological foundation, viewing it as part and parcel of the individual's life-struggle. Yet it is difficult to see wherein the so-called constructive method really applies, to the concrete dream, those biological conceptions of which it makes ostentation. The practical consideration of telling the patient what is good for him, and of keeping sexuality in the background seems to dominate the technique.[6] The interpretations are no more accurate than before. There is not much to choose between the reductive and the constructive method from the standpoint of the application of logic.



THE SUPPOSED LANGUAGE OF DREAMS

These reductions and constructions of the psychoanalytic schools appear to be rather favorite ways of guessing than rival scientific methods. Unquestionably, they must achieve a gratifying number of hits under the easygoing conditions of the psycho-analytic seance. This is obviously satisfactory to medical practice; but the danger to psychological theory lies in the temptation to overvalue the particular technique that seems to bring about such successes. For instance, Freud and Jung, finding it convenient to assume that the dreamer is attempting to express his latent thoughts by the use of metaphors and figures of speech, have unfortunately come to regard the behavior of the Unconscious Mind as if it were employing a secret archaic code or language of dreams. According to Freud, its symbols have very concrete meanings; Jung, more liberal, says they are only very general. But both authors seem to abuse the language-analogy as a guidance in dream interpretation. That is why psycho-analytic method today suggests not only the free play of poetic invention, but the license of mystical speculation.

If there is any present point in Emerson's remark that "Mysticism consists in the mistake of an accidental and occasional symbol for an universal one," then, in speaking to the psycho-analyst, the psychologist should echo Emerson further, and say: "Let us have a little algebra instead of this trite rhetoric— universal signs instead of these village symbols—and we shall both be gainers."[11]

The reason we shall need a little algebra, as it were, is that many psycho-analysts have fallen into confused ways of regarding their signs and significations.

Consider, for example, the reputed signs of the birth-phantasy, as listed by Freud:[12]

"A large number of dreams, often full of fear, which are concerned with passing through narrow spaces or with staying in the water, are based upon fancies about the embryonic life, about the sojourn in the mother's womb and about the act of birth." . . . Again, "There are dreams about landscapes and localities in which the emphasis is laid upon the assurance, 'I have been there before.' In this case the locality is always the genital organ of the mother; it can be asserted with such certainty of no other locality that one has 'been there before.' "

(What we should infer from the waking illusion of familiarity, which, Emerson said "almost every person confesses"—on this basis—is too absurd to contemplate.)

Statements like these, though far from syllogistic in form, are virtually general propositions or laws to the effect that all dreams having the designated earmarks or manifest content, possess additionally and necessarily certain specified qualities in the latent content—in this case, the meaning of birth-phantasy.[13]

Freud and Jung have stood sponsors for many such seemingly far-fetched interpretations. How do they come to be so sure of their ground?



EXAMINATION OF THE LANGUAGE-ANALOGY[14]

Let A represent the idea in the latent content and C the corresponding "symbol" in the manifest content. Suppose that in a number of cases a correlation is observed between A, the antecedent latent idea, and C, its consequent or sequential manifestation in the dream-consciousness. Thereafter, the observer comes to interpret the re-appearance of C in a dream narrative as a sign of the presence of the affiliated idea A, in the latent content. And, as Thomas Hobbes phrased the matter in 1651, the oftener they have been observed in like connection, the less uncertain is the sign.[15] Now this is precisely the way we come to recognize the verbal signs of our mother-tongue. And our confidence that a given speech C' is significant of a meaning A', in the speaker's intent, is arrived at by relying upon, if not consciously formulating, just such a causal connection. Where an existing language is concerned, this is a perfectly legitimate tooling of thought. But in applying such inferences to a supposititious language of dreams, psycho-analysts are begging the question, as well as running into other kinds of fallacy as to the powers of the Unconscious.

The meanings and significations of dream-items are not so simply made out as in language. For one cannot readily make sure that the relationship or affiliation between A and C has been observed in its purity; there is an uncertainty coming from the possible interposition of a variable factor, which may have vitiated the observation, as Alfred Sidgwick points out in his "Application of Logic."[10] So let us well consider the basis of any inference of meaning in dreams, and how far the language-analogy applies.



THE SOURCES OF MEANING

Fundamentally, every dream, yours or mine, consists of certain more or less clearly remembered images or ideas; and these are secondarily derived from some mental disposition previously or coetaneously acting in the background, as it were: i. e., persisting through its residual subliminal nervous dispositions. This anterior phenomenon is properly called the primary idea or image; the other, which appears (supraliminally) in the dream is called the secondary image or idea. The dream is thus made up of collocations and combinations of secondary images, to which is usually added a filling-in of fancy which may be called tertiary ideas: required, to find the primary ideas and so, the relation of one idea to another—which is the measure of "meaning."

Each secondary or tertiary image, in the absence of any immediate stimulus to account for it, may usually be traced back into a primary train of thought left unfinished during the day. This is the conception of the perseveration of the unadjusted, stated in 1891 by Delage, in giving his theory of dreams.[17] Its history runs back to Thomas Hobbes; and it has been amplified lately by Professor Woodworth, to whom I am indebted for unusually clean-cut illustrations of the applicability of the theory to dream-life. The principle is a most important contribution to the study of meaning in dreams.

More specifically, Prince, through his text-book on "The Unconscious," is the exponent of the idea that the elements of meaning reside in the primary ideas and must be sought there by highly specific investigations in the given case: "the meaning is in the fringe of thought." The meaning of a supraliminal image must be discovered in its relation to the subliminal ideas clustering around it. This implies studying by association-tests what James called the psychic overtones, and what Prince has, in his teaching, called the unconscious settings-of-ideas, which determine meaning.[18] Care must be taken to find the real determinants, and to set aside spurious dream material—which is not always facilitated by the psycho-analytic methods.

In order to show that one should not assume meanings by rule of thumb, without investigations of this kind, Prince has demonstrated a case in which typical phallic symbols, in a phobia of bells and towers, had acquired their emotional meanings, not through sexual analogies, as Freudians would suppose, but through actual contiguity-experience with church bells and belfry, quite apart from sexual matters.[18] Similarly, snakes, sticks, circles do not necessarily carry the sexual meanings assumed by psycho-analysts, who are over-influenced by the language-analogy.



DECISIVE VALUE OF CONTEXT AND APPERCEPTION MASS

To Freudians such statements seem paradoxical, to say the least; but the simple fact is that never is it correct to assume, as they do, a transcendental connection between a symbol C and a signification A, as if the Unconscious Mind disposed of ready-made symbols of its own. Barring words used in their proper sense, and similar borrowings from waking habit, the so-called symbols in dreams are essentially impromptu fabrications, in which the association is not a direct causal connection between A and C, but a mediate association involving a third element, which psycho-analysts usually leave out of account.

An element of this kind, overlooked in the formulation of a supposedly simple connection between cause A and effect C, is labeled Hidden Z, by Alfred Sedgwick. The Hidden Z in this case is what James calls the topic-of-thought, Ebbinghaus the set-of-the-mind, and others apperception-mass. In rhetoric it is familiar as context. It has an important place in thought and speech. For example, when I utter the phrase—Pas de lieu Rhone qne nous—the idea obtained is different according to whether your language apperception-mass is set for French or for English. It may have happened that while I was uttering the French nonsense phrase you were hearing it as the English saying. Similarly, the traveler in Egypt may correctly apperceive the meaning of architectural forms of temples as phallic; whereas it would be manifestly out of context to do so in connection with churchly edifices of the Gothic type, which do not represent the generative powers of nature, as do the former.

Conversely, the Freudian disciple may apperceive, in error, a sexual meaning in a dream, when the dreamer's mind contained no reference to this topic. Hence, the interpreter must make sure that his own apperception-mass is attuned to that of the dreamer in the given case. That is, one must be free from apperceptive bias. One must reject all hastily formed causal laws to the effect that C is the sign of A in every case. Otherwise absurd conclusions must result, as in Freud's theory of the birth-phantasies. For the same "symbol" may proceed from entirely different significations according to the set-of-the-mind or apperception-mass. The following analogy of Ebbinghaus puts the matter clearly: "When a train enters a large station there are many paths over which it might pass; but its actual path depends on the position which was given to the switches immediately before the train's arrival."[19] That is why one needs to detect, experimentally, the dream material that really represents the set-of-the-mind, and thence the significant relations called MEANING.

In this connection, I published a year ago the dream of a child of six, containing seemingly typical phallic symbols.[20] Not one of them could be correlated with a sexual context; but every one was concretely shown to have reached its position in the dream through the influence of an entirely different set-of-the-mind. It is, therefore, not safe to assume stereotyped meanings in dreams.



METAPHYSICAL CONCEPTIONS IN PSYCHO-ANALYSIS

There are three reasons why psycho-analysts do not more often encounter this variable element, this Hidden Z. First, such dreams as they elect to deal with, are mostly sexual. Second, they do not apply the methods of individual differences which have been made so familiar and so useful by Professor Cattell in this country.[*] Thirdly, their type of culture leads them to study the dream extensively rather than intensively and all the while in apparent disregard of those conceptions of physiological psychology which we now associate with the work of Wundt, of Ladd and of Woodworth, and with the psychopathology of Prince.

[*] The writer's present psychophysiological theory of dreams was first broached in public, at a series of meetings on the subject of Individual Differences, held in honor of Professor Cattell, at Columbia University, in the Department of Psychology, in April, 1914.

To be sure, Jung's recent utterances before the Psycho-Medical Society of London, demonstrate his dissatisfaction with the Freudian conception of the dream; but he is still far from those studies of specific mental and nervous dispositions to which psychology has slowly come, and for which we now have a tool in the shape of Prince's conception of the neurogram. In psycho-analytic work a more vague use of "dream material" is preferred and it is only by good luck that the real settings-of-ideas come into account. Jung, no less than Freud, has forgotten that philosophy has become mechanistic since Descartes'[21] famous year of 1637, and Jung would throw us back to the early seventeenth century, with his energic conception of the Libido, or the Ur-libido, now called Horme and sometimes merely elan vital. And this, fifty years after Herbert Spencer's tremendous emphasis on specific studies in reflex-action![22]

Fontenelle, the wittiest of Cartesians, writing in 1686, gives us a classic tableau of this sort of speculative temper. [23] He pictures worthies like Pythagoras, Heraclitus; Empedocles, as being invited to witness Lulli's opera "Phaeton," at the Paris Odeon. In characteristic fashion, each in turn tries to explain the spectacular aerial flight of the actor in the title-role, from the floor of the stage to the ceiling. One says, that Phaeton is able to fly by the potency of certain numbers of which he is composed; another, that a secret virtue carries him aloft; still another, that Phaeton travels through the air because he abhors to leave a vacuum in the upper corner of the stage; and so on, with a hundred and one speculations which, as Fontenelle remarks, should have ruined the reputation of antiquity. Finally, he pictures Descartes coming along and saying: "This actor is able to rise from the floor because he hangs by a cord, at the other end of which is a counterpoise, heavier than he, which is descending." This is mechanistic . . . If Freud and Jung had been of the party, can it be doubted that the one would have ascribed Phaeton's aviation to a wish-fulfilment of the flying-dream type, derived from a reminiscence of erotic motion-pleasure[24] in childhood, or that Jung, for his part, would have said Phaeton was levitated by the energic force of a sublimation of the Ur-Libido, alias elan vital, alias Horme!

* * *

VARIETIES OF DREAM INTERPRETATIONS

Let me illustrate these points of criticism of the psychoanalytic methods, by the analysis of a sample dream; speaking first as the dreamer giving the simple narrative; next as Freud applying the reductive method; then as Jung employing the constructive method; and finally explaining the dream, as I would myself prefer, by the use of what I may call the reconstitutive method. The dream itself, for reasons, that will be obvious, I call the "Scratch-Reflex Dream."

"I was looking down upon a microscope from the right side of the lens-tube, and could see, laid upon the stage, a glass slide. Under the cover-glass, in place of an ordinary specimen, there was supposed to be a new reflex,—one of those discovered by my friend the neurologist, Dr. X., whose scrawly handwriting I recognized on the label. I was anxiously trying to decipher what he had written, and was having the same trouble with it that I had experienced in real life with the record of some of his dreams, which I had interpreted successfully. The handwriting on the label, as I gazed, appeared less and less like script and more like disconnected, scratchy lines or hachures, owing to the formation of lacunae in the inky traces. It became scratchier and scratchier as I wakened. On coming to my senses . . . "

"That is enough," we hear Dr. Freud saying, "It is obvious what kind of reflex-action you have in mind! The word 'slide' is of a punning nature, and in conjunction with the easy moveability of the microscope-barrel suggests a meaning akin to that of dreams of skating and sliding, which are usually sexual. From the standpoint of symbolics, the geometric forms and relative positions of cover-glass and microscope suggest allusions to the generative powers of nature—like the phallicism of the ancient Egyptian religion, whose sacred emblems of sexual objects still confront the explorer and the tourist. Here, the 'stage' of the microscope refers obviously to the theatre, so often the scene of exhibitionistic activities. Your dream represents the male and the female principles in such a manner that it must mean a survival of infantile curiosity related to the mystery of parenthood. Sir, this proves your Libido to have been fixated at the 'voyeur' level."[25]