a-general-introduction-to-psychoanalysis-sigmund-freud

path of least resistance, and a most convenient solution for the principle of
pleasure. Through symptom formation the ego is undoubtedly spared a
severe and unpleasant inner task. There are cases where even the physician
must admit that the resolution of the conflict into neurosis is the most
harmless outcome and one most easily tolerated by society. Do not be
surprised, then, to learn that occasionally even the physician takes the part of
the illness he is battling against. He does not have to restrict himself to the
role of the fanatic warrior for health in all situations of life. He knows that the
world contains not only neurotic misery, but also real, incurable suffering. He
knows that necessity may even require a human being to sacrifice his health,
and he learns that by this sacrifice on the part of one individual untold
wretchedness may be spared for many others. So if we say that the neurotic
escapes the conflict by taking refuge in illness, we must admit that in some
cases this escape is justifiable, and the physician who has diagnosed the state
of affairs will retire silently and tactfully.
But let us not consider these special cases in our further discussion. In
average cases the ego, by having recourse to neurosis, obtains a certain inner
advantage from the disease. Under certain conditions of life, there may also
be derived a tangible external advantage, more or less valuable in reality. Let
me direct your attention to the most frequent occurrences of this sort.
Women who are brutally treated and mercilessly exploited by their husbands
almost always adopt the evasion of the neurosis, provided that their
predisposition permits this. This usually follows when the woman is too
cowardly or too virtuous to seek secret solace in the arms of another, or when
she dare not separate from her husband in the face of all opposition, when
she has no prospect of maintaining herself or of finding a better husband and
especially when her sexual emotions still bind her to this brutal man. Her
illness becomes a weapon in her struggle with him, one that she can use for
self-protection and misuse for purposes of vengeance. She probably dare not
complain of her marriage, but she can complain of her illness. The doctor
becomes her assistant. She forces her inconsiderate husband to spare her, to
attend to her wishes, to permit her absence from the house and thus free her
from the oppressions of her married life. Wherever such external or accidental
gain through illness is considerable and can find no substitute in fact, you can
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