Home > International Dictionary of Psychoanalysis > Conversion

The term "conversion" and its definition appear for the first time in an 1894 article by Freud titled "The Neuro-Psychoses of Defense." "In hysteria the incompatible idea rendered innocuous by its sum of excitation being transformed into something somatic, for this I should like to propose the name of conversion ....By this means the ego succeeds in freeing itself from the contradiction [with which it is confronted]; but instead, it has burdened itself with a mnemic symbol which finds a lodgement in consciousness, like a sort of parasite, either in the form of an unresolvable motor innervation or as a constantly recurring hallucinatory sensation" (1894a, p. 49). In the Freudian terminology of the time, an "irreconcilable" idea is a desire that is incompatible with the subject's moral ideals and consequently condemned and most often rendered unconscious.

Consequently, the concept is, from the beginning, located along the three axes that will structure all Freudian metapsychology: dynamic through the reference to "contradiction," which will later be theorized as "conflict"; topographical through the reference to the unconscious, which is still only allusive but will quickly assume major importance; and economic through the idea of a displacement of the energy (this will later become the libido) of the mind to the body. From this Freud draws a therapeutic conclusion: "Breuer's cathartic method lies in leading back the excitation in this way from the somatic to the psychical sphere deliberately, and in then forcibly bringing about a settlement of the contradiction by means of thought-activity and a discharge of the excitation by talking" (1894a, p. 50).

Freud initially considered the mechanisms of conversion to be specific to hysteria, unlike the other defensive psychoneuroses (obsessions and phobias). There would be a predisposition to hysteria for reasons he believes are probably constitutional, through what he refers to as "somatic compliance" in the Dora case (1905e). However, the "choice of neurosis," a problem to which he often returned, here finds only its modalities of realization; to these fundamental conditions must be added "trigger factors" rooted in personal history (childhood traumas such as early "seduction" experiences, that is, sexual assaults initiated by adults). This is Freud's position during the first period of his career. Later, in 1915, he distinguished "conversion hysteria," which used this mechanism to produce symptoms, from "anxiety hysteria," dominated by phobic mechanisms but without being accompanied by any conversion phenomena (1915d). He also acknowledged that minor conversion phenomena can be found in situations other than so-called conversion hysteria (1916-17a).

It is important to remember that Freud quickly established the necessity of distinguishing psychoneuroses—to which hysteria belongs—from actual neuroses (neurasthenia, anxiety neurosis, hypochondria), whose source is not found in infantile conflicts but in current disturbances of the sexual function (1898a). In such cases the accumulation of sexual excitation that has not been released or has been released by unsatisfactory means (coitus interruptus, masturbation, and so on) is reflected in anxiety and somatic symptoms (these views were modified in Inhibitions, Symptoms, and Anxiety, 1926d), but without the symbolic dimension inherent in conversion phenomena.

While the notion "actual neurosis" went into a long decline, modern work in psychosomatic medicine has given it new currency. It is used to describe somatic disturbances, often serious, that appear to arise from a form of interaction between mind and body where energy "passes directly" from the mind to somatic functions without symbolic mediation, that is, without "mentalization" of the psychoneuroses (Marty, 1980).

ROGER PERRON

See also: Cäcilie M., case of; Elisabeth von R., case of; "Fragment of an Analysis of a Case of Hysteria" (Dora/Ida Bauer); Hysteria; Hysterical paralysis; Innervation; Katharina, case of; Neurosis; Psychosomatic; Psychosomatic limit/boundary; Psychogenic blindness; Repression; Somatic compliance; Stammering; Studies on Hysteria; Sum of excitation; Symptom; Tics.