GENERAL THEORY OF THE NEUROSES
N the layman's eyes the symptom shows the nature of the disease, and cure means removal of symptoms. The physician, however, finds it important to distinguish the symptoms from the disease and recognizes that doing away with the symptoms is not necessarily curing the disease. Of course, the only tangible thing left over after the removal of the symptoms is the capacity to build new symptoms. Accordingly, for the time being, let us accept the layman's viewpoint and consider the understanding of the symptoms as equivalent to the understanding of the sickness.
The symptoms,—of course, we are dealing here with psychic (or psychogenic) symptoms, and psychic illness—are acts which are detrimental to life as a whole, or which are at least useless; frequently they are obnoxious to the individual who performs them and are accompanied by distaste and suffering. The principal injury lies in the psychic exertion which they cost, and in the further exertion needed to combat them. The price these efforts exact may, when there is an extensive development of the symptoms, bring about an extraordinary impoverishment of the personality of the patient with respect to his available psychic energy, and consequently cripple him in all the important tasks of life. Since such an outcome is dependent on the amount of energy so utilized, you will readily understand that "being sick" is essentially a practical concept. But if you take a theoretical standpoint and disregard these quantitative relations, you can readily say that we are all sick, or rather neurotic, since the conditions favorable to the development of symptoms are demonstrable also among normal persons.
As to the neurotic symptoms, we already know that they are the result of a conflict aroused by a new form of gratifying the libido. The two forces that have contended against each other meet once more in the symptom; they become reconciled through