v THE EVOLUTION OF PSYCHOTHERAPY 215
predisposed to the disturbances by constitutionally weak nervous systems. Janet retained the idea which was dominant in French psychiatry, that some sort of degeneration or weakness lay at the bottom of the neurasthenic (neurotic) type. Such persons started, he said, with a poorly integrated nervous apparatus. Freud was led to develop another view. It was not a constitutional weakness that predisposed to hysteria, but the neurosis was the result of unconsciously repressed memories with their emotional connotations.
In that period, neurasthenia was the diagnosis assigned to all nervous states characterized by depression, crying spells, headaches, weakness, nervous tension, irritability and fatigue. Freud noticed that some of his cases of neurasthenia differed from others in that anxiety was their chief symptom. Anxiety, he stated, was a specific nervous illness, occurring in those who could not relieve their normal sexual tension for one reason or another. Freud then postulated that unsatisfied sexual excitation was the cause of this anxiety. Sexual tension built up in an individual, being undischarged, was transformed into anxiety. In the sexual life of his patients, he discovered numerous instances of sexual preoccupations and activity and oftentimes reports of sexual assault in the childhood history. To his surprise, he found that the seducer was usually reported as being the father or an elder brother. As time went on, it was clear that many of these seductions were imagined, and that what he was really witnessing was the expression of a wish, a childish fantasy, to have relations with a parent or a sibling of the opposite sex. Thus Freud came upon the startling idea that actual sexual disturbances in his patients were no more important, so far as neurotic symptoms were concerned, than fancied ones. What he was saying was that sexual desire was not