=The Last Straw.= The precipitating cause may be one of a number of things. It may be entirely within, or it may be external. Perhaps it is only a quickening of the maturing instincts at the time of adolescence, making the love-force too strong to be held by the old repressions. Perhaps the husband, wife, or lover dies, or the life-work is taken away, depriving the vital energy of its usual outlets. Perhaps the trigger is pulled by an emotional shock which bears a faint resemblance to old emotional experiences, and which stimulates both the repressing and repressed trends and makes the person at the same time say both “Yes,” and “No." Perhaps physical fatigue lets down the mental and moral tension and makes the conflict too strong to be controlled. Perhaps an external problem presses and arouses the old habit of fleeing from disagreeable reality. Any or all these factors may cooperate, but not one of them is anything more than a last straw on an overburdened back. No calamity, deprivation, fatigue, or emotion has been able to bring about a neurosis unless the ground was prepared for it by the earlier reactions of childhood.
[Footnote 38: “The external world can only cause repression when there was already present beforehand a strong initial tension reaching back even to childhood.”—Pfister: Psychoanalytic Method, p. 94.]
="Two Persons under One Hat."= We can understand now why a neurotic can be described in so many ways. We often hear him called an especially moral, especially ethical person, with a very active conscience; an intensely social being, unable to be satisfied with anything but a social standard; a person with “finer intellectual insight and greater sensitiveness than the rest of mankind.” At the same time we are told that a neurosis is a partial triumph of anti-social, non-moral factors, and that it is a cowardly flight from reality; we hear a nervous invalid called selfish, unsocial, shut in, primitive, childish, self-deceived. Both these descriptions are true to life. A neurosis is an ethical struggle between these two sets of forces. If the lower set had triumphed, the man would have been merely weak; if the higher set had been victorious, he would have been strong. As it is, he is neither one nor the other,—only nervous. The neurosis is the only solution of the struggle which he is able to find, and serves the purpose of a sort of armed armistice between the two camps.