The medical-psychiatric origins of the psychoanalytical concept of narcissism

ABSTRACT:

In this article, our goal is to present some elements relatives to the history of appropriation of the myth of Narcissus by medical-psychiatric tradition, so trying to draw the origins of this important psychoanalytic concept. From a psychopathological point of view, the narcissistic phenomenon, defined initially as a particular form of fetish, began to be considered as a medical problem at the end of nineteenth century. The psychoanalytic appropriation of this notion was made in 1905, by Freud, with the introduction of the concept of autoerotism. The first psychoanalytical definition of narcissism itself, suggested by the Viennese psychoanalyst Isidor Sadger, was given in 1908.

Keywords:
narcissism; Autoerotism; history of Psychiatry; history of Psychoanalysis.

RESUMO:

Neste artigo, nosso objetivo será o de apresentar alguns elementos relativos à história da apropriação do mito de Narciso pela tradição médico-psiquiátrica, buscando assim traçar as origens do conceito psicanalítico de narcisismo. Desde um ponto de vista psicopatológico, o fenômeno narcísico, definido incialmente como uma forma particular de fetiche, começou a ser considerado um problema médico a partir do final século XIX. A apropriação psicanalítica desta noção se daria em 1905, com Freud, a partir da introdução do conceito de autoerotismo, sendo a primeira definição propriamente psicanalítica de narcisismo sugerida pelo psicanalista vienense Isidor Sadger, em 1908.

Palavras-chave:
narcisismo; autoerotismo; história da Psiquiatria; história da Psicanálise.

In the interior of the psychoanalytic tradition, the concept of narcissism emerges as an unfolding of the autoerotism notion - notion which was extracted from the psychiatric literature of the end of the 19^th century and assimilated by Psychoanalysis in 1905, since the thesis developed by Freud in his Three Essays on the Theory of Sexuality.

The first psychoanalyst to use the term narcissism was Isidor Sadger, in an article published in 1908, entitled Neuropsychiatric questions in the light of psychoanalysis. Such as Freud in the case of the autoerotism concept, Sadger appropriates a notion derived from medical-psychiatric tradition and thus proposes a reinterpretation of narcissism from a psychoanalytic point of view.

From that moment on, a long debate concerning the clinical phenomenon in question would be held amongst the members of the Vienna Psychoanalytic Society and last until 1914, when Freud would formalize the concept of narcissism, integrating it in a definite manner to the psychoanalytic theory.

Concentrating in the first two parts of this history - a history about the debates on what would later be defined as the psychoanalytical concept of narcissism, the objective in this article will be that of: (1) tracing the origins of the use of the term narcissism from the medical-psychiatric literature from the end of the 19^th century, which includes as well a preliminary study regarding the notion of autoerotism in the interior of the same medical-psychiatric tradition; (2) indicating the moment of transition in which the term narcissism is appropriated by the psychoanalytic thinking, from the researches of Sadger.

1 Autoerotism, narcissism and sexual perversion in the interior of the medical-psychiatric tradition

Both in the psychiatric or the psychoanalytic tradition, the notion of narcissism refers to the Greek myth of Narcissus, a narrative that would first take written form in the beginning of the Christian era, by the roman poet Ovid¹. It is about a myth that, in a few words, tells the story of a young man who falls in love with his own image. As shown by Vinge (1967) and Johansson (2012), the theme of Narcissus ended up crossing all the history of western literature; its presence in the medical discourse being a late movement and not at all evident. Such transition was marked by a sort of disenchantment from the original mythological narrative, and Narcissus would be detached from its particular symbolism, thus reduced in caricatured terms to a pathological emotion, its literal dimension, irrational - and therefore, negative.

Initially associated by Alfred Binet to a kind of fetishism, “the fable of the beautiful Narcissus” had been used at first as a model to the description of a particular case of Sexual perversion, in which the fetish of the subject in question would be the "object of the own person itself” (BINET, 1887, p.264n). As stressed by Binet, this somewhat general category of Sexual Perversion - inside which would be included the cases of fetishism - had been defined a few years earlier by the neurologist Jean-martin Charcot and by the psychiatrist Valentin Magnan as a hereditary syndrome resulting of a morbid disposition of the nervous system. According to these authors, all perverse symptom would be the episode of a more profound disease”, in this case of a “syndrome” manifested in those “subjects designated by Morel as degenerated” and which “since childhood carry the mark of a cerebral vice{tare}” (CHARCOT and MAGNAN, 1882, p. 297 - our translation). Binet (1887, p. 164), though in his work proposed to make a psychological analysis of fetishism, equally refers to this morbid disposition of hereditary character as being “the cause of causes”. As evidenced from the quotes, all Binet, Charcot and Magnan assumed a point of view greatly marked by Morel’s degeneration theory².

In any case, it is suitable to point out that while sexual perversion, this particular form of Narcissus' like fetish had been rarely brought up and discussed by psychiatric literature. Even Binet, who is responsible for the reference in question, does not dedicate to it more than a footnote. However, nonetheless its frequency, what matters to us here is to emphasize the fact that such phenomenon was initially present in the psychiatric speech as a representative of a hereditary syndrome, conceived in pathological terms as an expression of a degenerate state.

2 Autoerotism and Narcissus' like love as manifestations of the normal sexual activity

Nevertheless, from 1898, with the appearance of the autoerotism notion introduced by the English doctor Havelock Ellis in his article Autoerotism: a psychological study, this morbid dimension of narcissism would be partially relativized. The article would become a classic of specialized literature and many sexual phenomenon until then perceived as pathological - including narcissistic love - would come to be thought as expressions of the normal sexual activity.

2.1 The definition of autoerotism

In his article, Ellis provides the following definition to autoerotism:

By "auto-erotism" I mean the phenomena of spontaneous sexual emotion generated in the absence of an external stimulus proceeding, directly or indirectly, from another person. Such a definition excludes the normal sexual excitement aroused by the presence of a beloved person of the opposite sex; it also excludes the perverted sexuality associated with an attraction to a person of the same sex; it further excludes the manifold forms of erotic fetishism in which the normal focus of sexual attraction is displaced, and voluptuous emotions are only aroused by some object-hair, shoes, garments, etc.,-which to the ordinary lover are of subordinate though still indeed of considerable importance. The auto-erotic field remains extensive; it ranges from occasional voluptuous day-dreams, in which the subject is entirely passive, to the perpetual unashamed efforts at sexual self-manipulation witnessed among the insane. It also includes, though chiefly as curiosities, those cases in which individuals fall in love with themselves. Among auto-erotic phenomena, or on the borderland, we must further include those religious sexual manifestations for an ideal object, of which we may find evidence in the lives of saints and ecstatics. The typical form of auto-erotism is the occurrence of the sexual orgasm during sleep. (ELLIS, 1898a, p. 260)

From the definition, one can notice that “the weird and uncommon cases in which people fall in love with themselves” start to be taken as “phenomena of spontaneous sexual emotion”, phenomena which would be considered by the author as not necessarily pathological. Still according to the definition, one can observe that these same cases would be also differentiated by the cases of erotic fetishism arisen by objects, which would also problematize the delimitation made by Binet.

Seeking to illustrate the particular phenomenon of the narcissistic love, Ellis describes a case that would demonstrate precisely what would be called as Narcissus-like tendency. It is the case of:

(...) a lady of 28, of very large and fine proportions, active and healthy and intelligent, with, however, no marked sexual attraction to the opposite sex; at the same time she is not inverted, though she would like to be a man, and has a considerable degree of contempt for women. She has an intense admiration for her own person, especially her limbs; she is never so happy as when alone and naked in her own bedroom, and so far as possible, she cultivates nakedness. She knows by heart the various measurements of her body, is proud of the fact that they are strictly in accordance with the canons of perfection, and she laughs proudly at the thought that her thigh is larger than many a woman's waist. She is frank and assured in her manners, without sexual shyness, and, while willing to receive the attention and admiration of others, she makes no attempt to gain it, and seems never to have experienced any emotions stronger than her own pleasure in herself. (ELLIS, 1898a, p. 280)

Throughout his article, by contextualizing his new definition of autoerotism, Ellis concludes that some of the manifestations comprehended in it had already been approached by other authors. Amongst these, it’s relevant to point out the reference made to “Dr Laupts”, who introduces the notion of autophilia in a work entitled Perversion and sexual perversity (1896). Regarding this notion, although the English Doctor restricts its association to masturbation - described in a broad sense as “onanism”{vice solitaire} - it would be interesting to emphasize the passage in which Laupts expresses his definition, one that appears as an unexpected prelude to future psychoanalytical elaborations:

Onanism{vice solitaire} is related to autophilia, and autophilia to inversion. To love oneself it to invert oneself; to love one’s own organs is to prepare to love those of the neighbor. All the inverted or almost all are, then, in one way or another, autophilics. There is sexuality in their love for themselves. We are then before a point (one of the most important for the young ones) about which the therapist should put his attention to. (Laupts, 1896, p. 337 - our translation).

One can observe that Dr Laupts, pseudonym of Georges Saint-Paul (1870-1837), suggests in his text a relation between, on one hand, love to oneself, and on the other, sexual inversion - a parallel that years later would be reestablished by psychoanalytical researches.

Another interesting case, not quoted by Ellis in his 1898 article - although one that would also announce something that would later by sustained by psychoanalysis - is the one brought by Charles Féré, former student of Charcot in Salpêtrière and Binet’s colleague. In a work entitled Sexual instinct: evolution and dissolution (1899, p.257), Féré described the case of a 29-year-old young woman who, among other symptoms, presented that which the author called auto-fetishism. Since the age of 8, this young woman had been linked to a form of “masturbation” quite atypical; she would reach a high level of excitement by kissing the back of one of her hands, at times reaching an orgasm. While giving explanations about this practice, the patient describes a scene, probably occurred before she turned 8 years old, in which her mother, towards whom the young woman felt a great aversion, forcedly takes one of her hands and kisses it on its back. (1899, p. 261). As we will look at further, while approaching the psychoanalytical appropriation of the narcissism concept by Sadger, the relation of the child with the mother would develop an important part in the genesis of the narcissistic desire.

Returning to Ellis article, we should remember also that by proposing the notion of autoerotism, one of the goals of this author is to articulate such phenomena to the activities considered normal from the spontaneous sexual emotion. According to Ellis, such articulation would allow a better comprehension of the human sexuality (ELLIS, 1898a, p. 261). In these terms, the fact that the autoerotic phenomenon represents a subversion of the supposed natural goal of the sexual impulses - in this case, the genital sexual intercourse - will end up taking the author to the idea that human sexual behavior would be “unnatural”. That would also justify the parallel established between this behavior and other human realizations thought in sexual terms, such as art, moral and civilization in general (ELLIS, 1898a, p. 298). On the other hand, in psychopathological terms, the overview seemed to also shed a light on some enigma in the form of nervous affection quite discussed at the time - hysteria.

But in which way does Ellis relate these two phenomena, autoerotism and hysteria? To answer this question in a satisfactory manner, we should resort to the second version of Ellis’ text published in 1901 about autoerotism, in which the definition of autoerotism incorporates the following:

In a wide sense, which cannot be wholly ignored here, autoerotism may be said to include those transformations of repressed sexual activity which are factor of some morbid conditions as well as of the normal manifestation of art and poetry, and, indeed, more or less color the whole of life (ELLIS, 1901, p. 110)

It is here noticeable the influence on Ellis of the Studies on Hysteria, published by Breuer and Freud in 1895 - an article that he already quoted in the first version of his text, qualifying its authors as investigators that “seem to have thrown more light on its psychic characters{of hysteria} than any other recent investigators” (ELLIS, 1898a, p. 279). The emphasis here is drawn to the sexual “transformations” caused by the action of “repression” on the sexual activity and not on a supposed pathological nature intrinsic to these activities. The symptom is not, hence, the autoerotism itself, but the result of repression over the autoerotic impulses.

2.2 The Freudian critic about autoerotism

We know that in Three Essays on the Theory of Sexuality, Freud - in reference to the work of Havelock Ellis - makes use of the autoerotism notion and assigns it a central place in his argumentation. However, this appropriation is not done in a direct manner, and for us to understand it adequately, we are to suppose a mutual influence among the two authors - an implicit dialog that would have happened in at least two times: a first time in which Ellis appropriates some Freudian hypothesis and a second time in which Freud appropriates the appropriation itself that the English doctor would have made out of his work.

A first reference of Freud to Havelock Ellis can be found in a letter addressed to Fliess on January 3^rd 1899:

Something pleasant about which I had meant to write you yesterday was sent to me — from Gibraltar by a Mr. Havelock Ellis, an author who concerns himself with the topic of sex and is obviously a highly intelligent man because his paper, which appeared in Alienist and Neurologist (October 1898) and deals with the connection between hysteria and sexual life, begins with Plato and ends with Freud; he agrees a great deal with the latter and gives Studies on Hysteria, as well as later papers, their due in a very sensible manner. (MASSON, 1985/1986, p. 339).

The article sent by Ellis, which is here reported by the psychoanalyst, is Hysteria in Relation to the Sexual Emotions (1898b). In this work, the author (Ellis) dedicates a considerable portion of the text to the exhibition of hypothesis from “Viennese investigators”, about whom he would also affirm: “I venture to say,{that they} not only made the first really important contribution to our knowledge of hysteria since Charcot's investigations, but have opened the way to the only field in which the study of hysteria can now perhaps be fruitful” (ELLIS, 1898b, p. 608-9).

During that first stage, the matter of the dialogue would be limited to the appeal to sexuality as a possible etiological factor of hysteria - which, to Ellis, would go through a kind of transformation of autoerotism mediated by repression, a mechanism proposed by the Viennese investigators. It is about, therefore, the Ellisian appropriation of a Freudian hypothesis. In this sense, it is relevant to emphasize that, for the English doctor, the manifestation of the “sexual emotions” involved in the genesis of hysteria would be itself generated by the autoerotic needs (ELLIS, 1898b, p. 614).

Considering the scientific context of the time, the appeal to sexuality and the emphasis on its etiological function in some morbid conditions, as well as its influence on the determination of man’s nature, were not seen as great news. The German psychiatrist Richard von Krafft-Ebing, for instance, already called attention to the determining character of this powerful “natural instinct”{Naturtrieb} of sexual origin that would be, at the same time, in the genesis of certain pathologies and in the origin of moral nobility of the civilized man (KRAFFT-EBING, 1886/1894, p. 1 - our translation). In the case of this tradition, however, the comprehension of an instinct was subordinated to a precise definition of sexual emotions exclusively in anatomo-physiological terms.

Evidently, in Freud’s case, and later in Ellis’, the problem of sexuality would be approached in a different manner. By developing a critical thinking regarding the statute of sexuality, the first would then be conducted to the concept of autoerotism proposed by the second. We believe that such notion may have seemed useful to Freud as far as it would allow him to think in a very particular dimension of the sexual field - dimension which included the psychic aspect of eroticism. It would be therefore in this way that, in a second moment of this dialog, Freud would appropriate the notion proposed by the English doctor, using it as the basis to develop a new theory of sexuality. But how would that be done? What would be the modifications imposed by the Viennese psychoanalyst to the Ellisian hypothesis?

The first aspect to stress here is about an important differentiation established by Freud between an infantile sexuality and an adult sexuality, which means the diphasic aspect of the sexual development in human beings. From this first aspect we can derive a second one that, taking in account this distinction between an infantile sexuality and an adult one, would establish a differentiation between a autoerotism and a aloerotism. That is a differentiation that appears explicitly in the Three Essays of 1905 - when autoerotism would be associated with infantile sexuality and aloerotism to adult sexuality - though it could be observed a few years earlier, from Freud’s clinical work³. In short, it could be said that the criteria responsible for the establishment of such association were: (1) the infantile disposition and innate to autoerotic sexuality, capable of satisfying itself by the stimulation of the own body; and (2) the encounter with the external object that would mark the entrance in puberty and thus end the period of infantile sexuality, forcing then another way of satisfaction no longer based in autoerotism, but in aloerotism.

Having said that, we are then capable of evaluating these two times of dialog between Freud and Ellis: a first time in which Ellis appropriates the value attributed to sexuality by the Viennese psychoanalyst, no longer defined entirely in anatomo-physiological terms; and a second time in which Freud appropriates the notion of autoerotism developed by Ellis from the Freudian idea of sexuality assumed by the English author. In this second time of the dialog, it is possible to notice in which way Freud refines and concepts autoerotism - articulating it, at the same time, to neurosis, to psychosis, to perversions and to the history of civilization. Posteriorly, as we’ll see forward, this reinterpretation would be very important in the debate about Narcissism.

3 The psychopathology of narcissism and its relation with autoerotism

Although the Narcissus theme had already been explored in psychological terms and psychopathological by Ellis and Binet, the use and definition of narcissism as a psychopathological entity wouldn’t be made until 1899, by the German psychiatrist and criminologist Paul Näcke (1851-1913).

3.1. Paul Näcke and narcissism as pathological expression of autoerotism

As Ellis, Näcke would criticize the moralism related to matters of sexual order that seemed to dominate medical science at the time. In an article entitled A critical study on the problem of normal and pathological sexuality (1899a), the German psychiatrist calls attention to the difficulty in establishing a precise borderline between normal and pathological on what concerns sexual practices. According to Näcke, a lot of the practices censured in a determined place or historical context could be accepted otherwise in other contexts - situation which, added to the diagnostic difficulties to find the called “degeneration signs” in such cases, would make the question considerably more complex. By supporting in the work of the doctor and anthropologist Hermann Ploss, Näcke would even affirm that, given its frequency in some cultures, onanism, pederasty and other perversities, could not be properly described as pathologies - being at the most considered forms of indecency{Unzucht} (NÄCKE, 1899a, p. 358-9n). Having that in sight, Näcke (1899a, p. 358) assumes in methodological terms the following positions: to take as pathological only the “more pronounced cases of sexual perversity” and not those considered lighter and doubtful.

This would be the emergency context of the Narcissism notion{Narcismus}. The pathology in question would be classified, along with other cases of sexual perversity, by the German author as sufficiently pronounced, as a particular form of sexual activity marked by the “passion for oneself”{Selbstverliebtheit}. For Näcke (1899a, p. 375 - our translation), a classification such as this one would justify when the subject in question would demonstrate a very special kind of self-love, which according to the author would surpass the limit of “mere vanity”. Only “when the visualization of the self or of its parts is accompanied by clear signs of orgasm” would be possible to talk about narcissism. Therefore, in reference to cases like this, the German psychiatrist would finally evoke the notion proposed by Haverlock Ellis saying: “this would be the most emblematic case of auto-erotism in the H. Ellis sense.” (1899a, p. 375 - our translation).

In a second article, published on the same year and entitled The sexual perversions in an Asylum (1899b), the German psychiatrist would bring the same idea. Resuming the expression “passion for oneself” and, again from reference to Ellis, Näcke would take narcissism as the “most intense form of autoerotism”(NÄCKE, 1899b, p. 146 - our translation). From a systematic and statistical study of the sexual perversions found in the Hubertusburg asylum, the psychiatrist would get, however, to the conclusion that “true” cases of narcissism are quite rare. Of the more than a thousand cases observed, only five (four male patients and one female) could be classified as truly narcissists. Among the four male patients, the author points out the fact that one of them is hebephrenic⁴ and that the other three “stay in front of the mirror very frequently, contemplating themselves in front of it with pleasure” (NÄCKE, 1899b, 128-9 - our translation). In the case of the female patient, Näcke (1899b, p. 131 - our translation) affirms that the phenomenon could be observed only periodically, when the patient would show to be particularly excited; “during the outbreak, she would kiss herself, the arms and the hands, expressing absolute passion”.

Although the notion of ‘sexual perversity’ brought by the author in his text is rather wide, contemplating various “deviations of the sexual impulses” not necessarily pathological, such as masturbation, pederasty, exhibitionism, etc., it is worth to emphasize that all these deviations were observed in patients interned in an asylum for mentally ill. According to the Kraepelin classification, it was about patients diagnosed with “mental disorder”{Seelenstörung}, “paralytic dementia”{Paralytiker}, “idiots”{Idioten} and “imbeciles”{Imbecillen} (NÄCKE, 1899b, p. 123 - our translation). Once more, and in implicit opposition to Ellis, Näcke would be indirectly associating the narcissistic phenomenon to a pathological manifestation of sexuality. One of the patients indicated by the psychiatrist is also, as seen, diagnosed as hebephrenic - a clinical picture that would later be integrated to the sphere of Dementia praecox - which could lead us to the hypothesis that Näcke thought the Narcissism as a phenomenon perhaps linked to psychosis.

According to Ellis (1907, p. 208 - our translation), on the third edition of his article on autoerotism, these cases considered extreme - aside from being resumed by Paul Näcke - were yet reworked by the German doctor Hermann Rohleder (1907) and by the American Charles H. Hughes. Rohleder would make use of term automonosexualism and would consider the subjects with this diagnosis as carriers of a “congenital defect in the sexual center of the brain”. Hughes, on the other hand, would understand the autoerotic condition as a chapter of normal psychology, approximating it to the “aesthetic sentiment” and to the “admiration of nude in art”.

3.2. Isidor Sadger and narcissism as a phase of psychosexual development

The first psychoanalyst to use the term Narcissism with theoretic-clinical objectives was Isidor Sadger, then member of the Vienna Psychoanalytic Society. In Neuropsychiatric questions in the light of psychoanalysis, published in 1908, the author discusses precisely what would be called Narzismus in the context of infantile sexuality, from two clinical cases. One can notice here that the spelling in German is slightly different than the one proposed by Näcke⁵.

Seeking to advance in relation to older definitions, Sadger affirms that the love directed to one’s own self, from a psychoanalytical investigation, could be understood as the reproduction of a love - at times exaggerated - that was once given by the mother. In such conditions, the subject would gather, in the own body, the one who caresses and the one who is caressed. In the case of the first patient, a 29-year-old young woman, the analysis of certain fantasies would reveal a sort of reunion “of the mother and the child in the same body”, which would restore the early childhood. The same would be observed in the second case, of an 18-year-old man, whose analysis would reveal the same tendency. (SADGER, 1908, p. 54 - our translation). To sustain such affirmation, the author resorts to the notion of identification - in this case, identification with the mother.

The idea that the subject could gather in one’s own body both the one who caresses and the one who is caressed had already been intuited by the psychoanalyst a year before, when he would affirm the bisexual character of the hysterical fantasies observed during a hysterical attack (SADGER, 1907). Freud, who would publish in 1908 his short article about Hysterical fantasies and their relation to bisexuality, would recognize this independent discovery of Sadger in a footnote (FREUD, 1908b/1996, p. 154n). Naturally, the same could be said about the notion of identification - which would be resumed by Freud only one year later in Some general remarks on hysterical attacks (1909).

It is known that Freud had already used the term identification{Identifizierung} in the Interpretation of Dreams while approaching the problem of “hysterical identification” (FREUD, 1900/1996, p. 183). In such case, however, this notion would represent no more than a “psychic act” proper to the hysterical way of relation to the object. On the other hand, with Sadger, identification begins to be thought as a more fundamental event - one that would have place in the context of infantile sexuality (SADGER, 1908, p.54). In sum, what is being said once more is that, in a determined moment of the psychosexual development, the subject will be taken by the own self as an object, having the maternal love as investment model.

Another point brought up by Sadger - which seems, on the one hand, to be based in an article published by Näcke in 1906 and, on the other, in previous researches made by the psychoanalyst himself - is about the relation between Narcissism and homosexuality.

According to Näcke, who explicitly praises Freud’s Three Essays, the homosexual desire or even bisexual should be understood as a possible destiny of the “sexual impulse{Geschlechtstrieb} recognizably undifferentiated” which marks one’s autoerotic infancy. While referring to autoerotism, the psychiatrist reports textually to Ellis and Freud, claiming that it is about a “phase” during which one does not establish any relation with a “foreign sexual object”{fremdes Sexualobjekt} (NÄCKE, 1906, p. 588 - our translation). Once this phase is passed, however, the heterosexual impulse would finally come with the conquest of the external object - impulse which at times could be filled with homosexual tendencies; such mixture would, according to the author (Idem, 1906, p. 599), depend of the character more or less intense of certain precocious experiences, which would give substance to his theory of constitutional bisexuality. In this context, Näcke would draw attention to the fact that “in the rare case of narcissism”, there would also be a homosexual impulse that would manifest through the autoerotic way and that, notwithstanding, would take the image of one's self as a stimulus to sexual excitation. In this matter, not every case of homosexuality would be a case of narcissism, but every case of narcissism would be, somehow, associated to homosexuality and to the inaptitude to objectual love. Having said that, the author exemplifies briefly quoting two cases, both diagnosed as cases of Dementia praecox. One of them is that of a young woman who masturbates smiling and sending kisses before her own image, and the other is that of a woman who does the same while kissing her own arms (Idem, 1906, p. 603).

In his article of 1908, Sadger builds a similar reasoning. He goes forward, though, bringing up the hypothesis of precocious identification between the narcissistic future and the mother, which, in turn, would prepare the field for the emergence of homosexual fantasies that would mark the narcissistic choice of object. It seems, however, that unlike Näcke, Sadger does not look to situate Narcissism in the field of Dementia praecox. In this sense, the distinction between these patients called narcissists and the common neurotics would reside only in the then recent found field of identification and posterior choice of object, existing no relation, at first, between them and the clinical picture of Dementia praecox. In the Vienna Psychoanalytic Society meeting of May 27^th, Freud, by bringing fragments of a “latent homosexuality” case, would confirm these hypothesis of Sadger, which, according to him, would be also found in a book published by Wilhelm Stekel. (NUNBERG and FEDERN, 1962, I, p. 416 - our translation).

In this sense, it is interesting to observe in which way the notion of narcissism was little by little being associated to the idea of inaptitude to objectual love, what would from then guide the psychoanalytic comprehension of Dementia praecox. Abraham (1908/2000), in an important article about the theme, Ferenczi (1909/2011, 1911/2000) and Freud (1911/1996), with the publication of the Schreber Case, would develop this question providing the necessary resources to think the relation between homosexuality, paranoia and narcissism. The same can be said about the work of Rank (1911/2016). This problematic surpasses the objectives of this article and therefore won’t be here discussed.

3.3 Narcissism and the impasses of identification in Sadger and Freud

From psychoanalytical research, the theme of Identification appears in the context of the debate about homosexuality - problem that, in turn, precedes the discussion about Narcissism. In his article of 1908, Sadger refers to precocious identification with the mother as the responsible for the prevalence of the homosexual component of the sexual impulse. One year later, however, in a presentation that would take place in the Vienna Psychoanalytic Society, the debate would deepen from the discussion of a case of male homosexuality in which the homosexual desire of the patient in question would be aroused by the way of looking and the joviality of some men. Such aroused desire was directed to the genitals of these men. Through analysis, these traces could be recognized in a babysitter that had manipulated the genitals of the patient when he was around seven or eight years old, which led the psychoanalyst to conclude that, “as a homosexual”, this patient “identifies with the mother while woman who seeks the satisfaction of her lover”⁶ (NUNBERG and FEDERN, 1962, II, p. 299 - our translation). Having exercised the roll of mother, it would be, then, the babysitter - while woman who seeks the satisfaction of a man - that would appear as the object with which the patient identifies, object that assembles narcissistic and objectual elements.

Having said that, Sadger then makes use of the notion of Narcissism allied to Autoerotism, claiming to be precisely a retake of “autoerotism in the form of narcissism” what is at stake in the desire of these homosexual patients (NUNBERG and FEDERN, 1962, II, p. 301). The search of the mother to satisfy her lover, search that would take the subject itself as object, would constitute then as a narcissistic fantasy. In this way, the homosexual object choices that would be made in the future by these subjects could be explained based in this fantasy, whether in the search for objects of the same sex that present the features of the seductive mother, whether in the search for objects of the same sex capable of representing the own subject as object of the mother’s love.

Such arguments, given by the psychoanalyst, are faced by the Society with disbelief in the session of November 10^th 1909. Alfred Adler questions the intensity of the identification of this subject with the mother, Max Eitingon sustains that narcissism cannot be taken as a particular case of autoerotism, Paul Federn, though praises the presentation of the case, problematizes some aspects of the Sadgerian thesis in the choice of homosexual object.

Freud, when taking the floor, though reiterating a few criticisms drawing attention to the excessively speculative character of Sadger’s opinions, signals the potentiality of the Narcissism notion brought by the author, which he sees, in this occasion, as a “new and valid” notion. In the words of Freud: “Narcissism is not an isolated phenomenon, but a stage of the necessary development in the passage from autoerotism to objectual love. To love oneself (love its own genital organs) is an indispensable stage in the development.” (NUNBERG and FEDERN, 1962, II, p. 307 - our translation). Next, he points to the “two primary sexual objects” of man, arguing that one’s ulterior life will depend on which the individual remains fixed to. These two sexual objects would be: “the woman (mother, babysitter, etc.) and the own self”. That said, Freud goes on asserting: “it is important to liberate from both and not delay in abandoning them, not remaining around them for an overlong time”. (Idem, 1962, II, p. 307 - our translation). Normally, continues the psychoanalyst, it is the figure of the father that comes to undermine this relation, what could be understood as a critical moment during the development. In case the individual is not capable of liberating very early from the own self, one will carry a homosexual trace for life. (Idem, 1962, II, p. 307).

Three weeks later, in the session of December 1^st 1909, Freud resumes the same thinking while approaching a fantasy of Leonardo da Vinci, communication that would later be broadened and published as Leonardo da Vinci and a Memory of His Childhood (1910/1996). Textually quoting Sadger, the author would propose that Leonardo was marked by an enormous maternal fixation that had been placed in his childhood years - situation that would have determined his homosexual character. Here, it would be thus from the hypothesis presented by Sadger, of a possible homosexuality case marked by the repression of the strong precocious love awaken in the artist for the mother. One should remember that homosexuality, as a sub-product of the repression of one’s love for the mother, was part of the hypothesis initially proposed by Sadger, being one of the possible outcomes of the identification with the mother. Having said that, Freud would finally present the following panorama of the mechanisms at issue:

The unfolding of certain homosexuality cases show that, during the first period{of life}, an intense fixation to the mother is produced; it is then repressed, being from there that occurs the great change. The homosexuals divide in two groups, according to the primary sexual object that they choose; these two primary objects are the woman (the mother, etc.) and the subject itself. (NUNBERG and FEDERN, 1962, II, 337-38 - our translation)

Conclusion

From this moment on, the notion of Narcissism - thought in its relation with homosexuality and with the aforementioned phases of the psychosexual development - would then begin to gain the statute of concept. In addition to approaching it in the analysis that he makes of Leonardo’s biography, Freud would still include, in 1910, these reflections concerning such recent notion in the second edition of the Three Essays. Next, one can observe the appearance of Rank’s work (1911/2016) entitled A contribution to narcissism, in which the author approaches the matter of feminine homosexuality from the concept in question, and again of Freud (1911/1996) who would introduce the same concept in the debate on paranoia. Finally, in 1914, in On narcissism, the concept would be consolidated by Freud.

In this article, we do not occupy ourselves with the continuation of this history from 1910, but with the analysis of a context that was directly previous to it; the goal here was precisely to explore what would have provided the bases to these latter elaborations. In these terms, by tracing the origins of the concept of Narcissism, this article situated its genesis in the medical-psychiatric tradition and observed its evolution in the interior of the same tradition, showing, ultimately, in which way such concept could finally be appropriated by psychoanalysis.

As seen, such appropriation was given through intermediate of two non-psychoanalysts researchers, Havelock Ellis and Paul Näcke, authors who redirected the debate about sexuality, creating conditions so that the psychoanalytical hypothesis could then develop. In sum, one can say that such debate took place: (1) around the question raised by Ellis of autoerotism as non-necessary pathological manifestation of sexuality; (2) in the ideas of Näcke about love for oneself as a stage in the development that involves the alienation of the subject in relation to the external world; and, finally, (3) with Sadger and Freud who - by collecting all the material resulting from the experience of other researchers - were capable of reorganizing it from the psychoanalytic experience. Gradually, the notion of narcissism would no longer be considered in purely descriptive terms, to be then thought in dynamic terms and, at last, articulated to the subjectivity of the patient in the determination of his symptom.

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• 1
  The Metamorphoses, book III, 402-510. In the third book of this work, composed by 733 verses, the part dedicated to the narrative of Narcissus is from verse 399 to verse 510.

• 2
  The reference here is to the conception of mental illness exposed in the Treatise on the degeneration, from Benedict-Augustin Morel, published in 1857. This treatise would exert great influence on European psychiatry, taking a dominant position inside the medical field until the beginning of the 20^th century.

• 3
  I quote here in particular the article Sexuality in the Aetiology of the Neuroses, of 1898.

• 4
  The condition of Hebephrenia, initially described by Karl Kahlbaum, would be later approached by Kraepelin as one of the forms of Dementia praecox, along with the catatonic and paranoid form. According to Kraepelin, the symptoms of the hebephrenic form include, among others, delusions, hallucinations and increase of sexual passion and promiscuity in some cases (KRAEPELIN, 1907, p. 230s).

• 5
  About the different forms taken by the term narcissism, see Padovan and Müller (2016).

• 6
  This second case, reported in three meetings at the Society, would be published in 1910 under the title: Ein Fall von multipler Perversion mit hysterischen Absenzen {A case of multiple perversion with hysterical absences}. The etiological formula in question would be discussed in three other articles published between 1908 and 1909.

Publication Dates

• Publication in this collection
  Dec 2017

History

• Received
  03 Jan 2015
• Accepted
  29 May 2015