The Neuro-Psychoses of Defence: Freud’s Early Theory of Psychological Conflict

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In today’s episode, we’re going back to 1894 to explore a paper by Sigmund Freud called The Neuro-Psychoses of Defence. This is one of Freud’s early attempts to explain how the mind protects itself from emotional pain.

My name is Simone. I’m a psychoanalyst, and I’ll be your host for this episode.

The Neuro-Psychoses of Defence

In this paper, Freud suggested that some of the most confusing mental conditions observed at the time were not simply disorders of the brain. Instead, he argued they were the direct, logical – though unintended – results of the mind’s own defence system.

In the late nineteenth century, doctors were seeing patients – especially women – who presented with strange physical symptoms, such as paralysis or blindness, even though there was nothing physically wrong with them. At the time, doctors described this as a “splitting of consciousness.” Yet there was no real agreement about what caused it.

And this is where Freud changed the picture completely. While his colleagues had their own explanations – Pierre Janet saw it as a sign of an inborn mental weakness, and Josef Breuer, Freud’s mentor, believed it occurred in dream-like states – Freud went in a very different direction.

Freud’s position was this: the problem was not weakness, but action. Not something the mind lacked, but something it was doing. The mind was actively pushing something away. This was not fully conscious, but it was intentional. And this idea marked a major shift in how mental suffering was understood. This pushing away brings us to the core of Freud’s new idea: defence.
Freud suggested that the mind has a built-in way of dealing with thoughts and feelings that feel simply too painful or too overwhelming to face. When something threatens inner balance, the mind doesn’t try to solve it rationally. It tries to protect itself.

The trigger for this process is what Freud called an incompatible idea. This can be a memory, a thought, or a feeling that clashes deeply with how a person understands themselves. It creates a conflict that feels unbearable, as if two versions of the self cannot exist at the same time.

Freud observed that very often these incompatible ideas were connected to a person’s sexual life. This created a contradiction the mind felt it could not tolerate. Rather than resolving the conflict, the mind chooses a different solution: it pushes the idea away.

And this, for Freud, was the beginning of symptoms as the result of the mind actively defending itself against inner pain.

So at this point, we can see defence coming into play. And Freud lays out, in a very practical way how this process works step by step.
• First, the incompatible idea appears.
 A thought, memory, or feeling rises up – and it creates immediate inner conflict.
• Second, the ego pushes it out of conscious awareness.
 Freud called this repression: the mind removing something from awareness because it feels unbearable to face.
• And here’s the crucial point: we can push away a thought, but we can’t erase what you feel.
The emotion attached to that idea – the affect, meaning its emotional charge – doesn’t simply disappear.
So in step three, the idea becomes cut off from its emotional force. The thought is weakened, muted, almost as if it has been disconnected.

But now there’s a new problem.

That emotional energy still exists.
 And it has to go somewhere.
And that emotional energy goes straight into the body. Freud argued that this is exactly what happens in hysteria. The mental energy doesn’t disappear – it simply finds a physical home.

Freud called this process conversion. In simple terms, psychological pain is converted into a bodily symptom – a physical problem

From the mind’s point of view, this works. The ego is relieved. It no longer has to face the disturbing thought or memory.
But there is a cost.
The body is now left carrying what Freud called a mimic symbol – a physical trace of the inner conflict. It’s a kind of bodily memory.

This is the essence of the idea:
 the conscious mind gets to forget the trauma or the forbidden desire, but the emotional energy still has to go somewhere. And it becomes lodged in the body as a real physical symptom.

Freud gave examples such as:
• a paralysed leg
• a chronic cough
• a blind eye
The mind forgets.
 But the body keeps the score.

But what happens if someone can’t do that, as Freud put it, a person lacks the aptitude for conversion? If the body isn’t an option, then that emotional energy has to remain in the mind, at this point, it takes a very different path. Freud calls this path false connection. Here, the feeling itself – anxiety, guilt, fear – does not disappear. Instead, it gets redirected. It attaches itself to a completely different idea, often one that seems random or harmless.
Suddenly, this new idea becomes charged with an intensity that makes no logical sense. It turns into a powerful obsession or a phobia. The emotion is real and unchanged.
 Only its target has shifted.
So the person feels overwhelming fear or anxiety, but the thing they are afraid of is no longer the true source of the conflict.

Freud gives a very concrete example of this in his paper. A young woman became afraid that she would suddenly need to urinate in public and wouldn’t be able to control herself. This fear began after one moment in a concert when she actually had to leave during the performance because she felt the urge to urinate. Over time, the fear grew so strong that she stopped enjoying social events and avoided going out unless she knew a toilet was close by and easy to reach without drawing attention. Nothing was physically wrong with her, and at home or at night she never had this problem.
A detailed examination showed how the fear started at a concert where a man she liked had taken a seat near her. She began daydreaming about being with him as his wife. While imagining this, she felt a sexual sensation that, for her, usually came with a slight need to pee. She normally didn’t mind this, but this time she became frightened because she had decided to push away any romantic or sexual feelings. Her fear then shifted from the sexual feeling to the urge to urinate, and that panic made her leave the hall. In daily life she was very modest and uncomfortable with anything related to sex, yet she often had strong feelings during her fantasies. The concert episode made the physical sensation feel dangerous, and the fear attached itself to the idea of needing to pee. With treatment, she eventually gained almost complete control over this fear.

Now, in this same paper – the Neuro-Psychoses of Defence – Freud described another form of defence — one he saw as both the most successful and the most catastrophic.
Here, the mind is not converting emotion into the body, and it is not redirecting it onto another idea. It is doing something far more radical.
As Freud put it, the ego behaves as if the incompatible idea never happened at all. This is not repression. It is a complete and explicit rejection.
And this defence comes with a very high cost.
This incompatible idea isn’t just a thought disconnected from reality or context. It’s tied to a real piece of the external world. And if the mind is going to reject the idea entirely, then it must also reject the part of reality connected to it. This, Freud argued, is what happens in psychosis. The mind preserves itself by breaking with reality itself.

In this paper – the Neuro-Psychoses of Defence – Freud shared another story of a young woman who fell deeply in love with a man and truly believed he loved her back, but she was mistaken, because the man had his own reasons for visiting her home that had nothing to do with love. She kept facing little disappointments, but each time she pushed them away in her mind so she could keep believing that he would one day ask to marry her, even so, she felt both sad and unwell, because she couldn’t fully block out the truth and new hurts kept appearing. One day, during a family celebration, she expected him to arrive. She waited with growing tension, watching every train come and go. When he still didn’t come, something in her mind gave way. She slipped into a confused state where she imagined he had arrived after all. She heard his voice in the garden and ran downstairs in her nightgown to meet him.
From that moment, she spent two months living inside a happy dreamworld. In her mind, he was with her constantly, and everything was as it had been before the disappointments began. Her sadness and physical symptoms disappeared. She stopped talking about all the doubts and pain she had gone through. She felt peaceful as long as no one interrupted her dream, but reacted angrily whenever someone tried to stop her from doing something that, in her dream-state, made perfect sense.
This mental episode, which no one understood at the time, was only explained ten years later during a hypnotic session that uncovered what had happened in her mind.

So, to summarise Freud’s idea:
• In hysteria, emotional energy is expelled from the mind and settles in the body as a physical symptom.
• In obsession, the energy stays in the mind but becomes attached to a substitute idea.
• In psychosis, both the incompatible idea and the piece of reality linked to it are rejected entirely.