He argued that allpatients were genitally disturbed: that is, they did not achieve full
satisfaction in sexual intercourse. Reich’s discussion of incomplete sexual gratification had
explicit connections with some of Freud’s early formulations. In 1905, Freud had remarked
that “no neurosis is possible with a normal vita sexualis.”^4 The classical psychoneuroses
studied by Freud hysteria and obsessional neuroses were rooted in infantile sexual conflicts.
Freud posited another set of neuroses, and applied the term “actual neuroses” to
those that resulted from present-day (aktuellein German) disturbances of adult sexual life.
Thus, the two forms of “actual neuroses” anxiety neurosis and neurasthenia were distur-
bances that were the immediate result of damned-up sexuality. Anxiety neurosis was caused
by sexual abstinence or coitus interruptus. It had to be distinguished from neurasthenia,
which was caused by “sexual abuse,” such as “excessive masturbation,” and characterized by
back pains, headaches, inability to concentrate, and feelings of fatigue.
Actual neuroses, unlike the psychoneuroses, were not amenable to classical analyt-
ic treatment. They were treated by eliminating the harmful sexual practices that led to the
“damming up” of sexual energy. However, exactly why a patient engaged in such harmful
sexual practices in the first place was not clear in Freud’s formulation.
If Freud distinguished clearly between psychoneuroses and actual neuroses, Reich
came to believe in a strong relationship between the two sets of neuroses. He argued that
without some kind of psychic inhibition, there would be no “actual neuroses,” for why else
would a person abstain from or abuse sex? (Later, Reich would also emphasize social factors
such as the unavailability of contraceptives that could contribute to the development of
actual neuroses.) At the same time, Reich argued that the actual neuroses provided the driv-
ing energetic core of the psychoneuroses. “Where did they (the compulsions and hysterias)
derive their energy from? Undoubtedly, from the actual neurotic core of the dammed-up
sexual energy.”^5
In the relationship between actual neuroses and psychoneuroses, Reich detected a
reciprocal interaction,the kind ofinteraction he was later to emphasize in diverse realms.
He saw the reactivated infantile conflicts, in the form of a psychoneurosis, as further imped-
ing adult genital function, thereby intensifying the actual neuroses, and so on in an endless
vicious circle.However, there was also the possibility of a beneficent circle. A fulfilled sex-
ual life with no actual neurosis could lead to a withdrawal of energy from early childhood
conflicts. The reduction in infantile inhibitions in turn facilitated ever more gratifying adult
love relations. Indeed, in his first article on genitality, Reich claimed that this was happening
in his successful cases. He argued that those patients who improved were able, with help
from analysis,to maintain the kind of love life that drained off energy from the infantile
conflicts. The unconsciousmaterial was not so much worked through in detail as it was
deprived of the “water” that had previously stimulated its malignant growth.
We can note here two parallel lines, the convergence of which Reich did not initial-
ly emphasize. In the technical seminar, Reich was concerned with describing the conditions
under which the interpretation of repressed material was effective. It was important for the
patient to remember with affect by means of the systematic analysis of resistances. Initially,
90 Myron SharafFury On Earth