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Freud fids this state of affairs "a nece
ssary correlate
ly requisite." In the further
course u treatment, the patient supplies
acts, known all along, that
had been kept back of had not occurred previously and gaps inaemory are 
also filled. Thus, Freud concludes, it is only towards the end of
analysis that case history emerges that is intelligible, consiste Email
and unbroken.
The practical aim of treatment, Freud suggests, it twofold: 1) the aim is to remove all possible symptoms and replace them with conscious thought; and, 2) secondarily, to repair all damage to the patients memory. The two aims, Freud says, are coincident. (18)
On pages 18-23 Freud begins to describe Dora`s case history by taking into account the personal and social circumstances of the patient and her family. In an nutshell, at 18 years old Dora has a family that consists of the parents and one brother. The father is depicted as being domineering and this therefore provides a framework by which one can understand the nature of Dora`s childhood and illness. Thus Freud points out that Dora, as child had nursed her father who was suffering from tuberculosis and yet was a very critical person. It is the case that Dora did not get on well with men.
On page 28 Freud makes several comments regarding his new technique of analysis. In this new technique Fred abandons the emphasis on the so called `hypnoid state,` which as supposed to appear in patients as a result of the trauma and to be foundation for all the psychologically abnormal events that subsequently took place in the individual's life. (see: Footnote #1 in the text). That is, Freud wishes to point out that it is often the case that the trauma of a person's past life is not enough to explain or determine the particular characteristics of the symptoms. In Dora`s case the trauma is said to have occurred at the age of 14, and thus it was necessary for Freud to look into her infantile memories.
In looking at Dora`s symptomatology, Freud points out that her symptoms are characterized by a reversal of effect. That is, there was a case in which a man (Herr K) is said to have kissed the patient when she was a young girl and the result was that Dora`s sexual excitement was reversed into feelings of displeasure. (28) Freud also points to an instance of displacement related to this trauma. That is, instead of reacting to the kiss with genital excitement, Dora`s mucus membranes secreted fluid and thus helped cause the aforementioned displeasurable sensations. (29)
Freud continues by noting that three symptoms were created through one traumatic instance. These three symptoms include the following:
On page 35 we find Freud making more comments regarding patient behaviour while in analysis. He notes that when a patient brings up a sound and incontestable argument during analysis, it soon becomes apparent that the patient is using thoughts of this kind for the purpose of cloaking other thoughts, which are said to be anxious to avoid criticism and consciousness. That is, such argumentation is an instance of defense. Freud also notes that "a string of reproaches against other people leads one to suspect the existence of a string of self-reproaches with the same content. In such instances, Freud suggests, all that is necessary is to turn such reproaches back onto the patient. This is a particularly interesting point, as we know in paranoids self-reproaches are projected onto others with there being no alteration in the content.
On page 40 Freud comments that hysterical symptoms require the participation of both an individual's somatic and psychical sides. In terms of cleaning up a symptom, he notes that the analyst is more interested in the patient's psychical symptoms. (41) In terms of self- reproaches, the analyst, Freud says, is usually faced with the task of guessing and filling n what the analysis offers to him or her in the shape of hints and allusions. (42)
In terms of the motives of the illness, Freud comments that the primary motive does not share in the formation of the illness and is not present at the beginning of the illness. (see: footnote 1: Freud comments that falling ill serves the function of economic, i.e., it saves the individual from psychical effort when there is mental conflict). The secondary motives, conversely, are said to be of an external nature. That is, some psychical current or event finds use of the motive and thus a resistance develops. (42)
Motives for becoming ill are said to begin in childhood. What Freud means by this is that a child quickly learns that illness is a means of eliciting the parents` love. Thus, Freud concludes that as soon as there is enough psychical material for the child to make use of, then the child will use that means of manipulation. Freud makes a characteristically sexist statement when he suggests that this is the basis of a female's manipulative behaviour as an adult and this behaviour is said to be transferred into the marriage situation. In such instances, says Freud, a state of ill health will in every appearance seem involuntary and objective. Therefore, the patient find themselves not required to feel any guilt or remorse as a result of the successful use of such means to gain attention that were learned in childhood. From this Freud concludes that illnesses of this kind (e.g., Dora`s case) are the result of the intention to gain attention. Such intentions are said to be leveled at a particular person and the illness is reported to vanish when that individual departs the scene. I is important to note, however, that such intentions are largely unconscious behaviors and to overlook this motivation of illness is only permissible in relations to children. Freud continues to comment that combating motives of illnesses is the weak point in every kind of therapeutic treatment of hysteria. Therefore, he concludes, the analyst need only remove the motive and the result might possibly be a permanent cure. (44-45)
Freud continues to make some last comments regarding motives of illnesses. He states that motives that support the patient in being ill are probably to be found in all fully developed cases of hysteria. (46) Freud notes that he has found it to be the case that at least one meaning of every hysterical symptom signifies the representation of a phantasm with a sexual content. That is, such meanings refer to a sexual situation (yet there may also be other meanings). (47)
On page 48f Freud argues for the propriety of sexual discourse in analytical treatment of the neuroses. He say that the analyst is not in a position to condemn the sexual phantasies of an individual. "The sexual life of each one of us," he writes, "extends to a slight degree-- now in this direction, now in that -- beyond the narrow lines imposed as a standard of normality." (49) That is, Freud wishes to point out that perversions are neither bestial nor degenerate in the emotional sense of the word. Rather, they are the development of germs contained in the undifferentiated sexual deposits of the child, which by being suppressed are diverted or sublimated to higher, asexual aims. They are "...destined to provide the energy for a great number of our cultural achievements." From this point of view, a person doe not become a gross pervert, rather he or she remains one. That is, the person exhibits a certain stage of inhibited development. "Psychoneuroses are," Freud concludes, "so to speak, the negative of perversions." (49) That is, they are the result of the disturbed development of normal sexuality.
On page 51 Freud writes the following: "The motive forces leading to the formation of hysterical symptoms draws their strength not only from repressed normal sexuality but also from unconscious perverse activities." He notes that it is often the case that a single symptom corresponds to several meanings simultaneously and/or in succession.(53)
Supervalent thoughts, like obsessions, are said to
be symptomatic of melancholia and can be cleared up through psycho-
analysis. Such thought consist of excessively intense trains of
thought that must owe their reinforcement to the unconscious and are
often directly contrary to a repressed thought. The relation between
these two types of thoughts, repressed and supervalent, is said to be
an affect of the process of repression. That is, repression is often
achieved through excessive reinforcement of the held contrary to the
one repressed. This called active reinforcement
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