This document summarizes Sigmund Freud's differentiation between "inhibitions" and "symptoms" in his clinical notes. Freud defines inhibitions as a mere restriction of ego function, while symptoms indicate a pathology requiring treatment. He uses typical forms of inhibition like psychosexual impotence to show how they can become symptomatic if a neurotic subject attributes sexual meaning to them. Freud analyzes common fantasies and fears behind inhibitions, like the "vagina dentata" fantasy, and how patients respond to inhibitions, to determine if they remain temporary or become traumatic symptoms.

1. 1
CLINICAL NOTES
ON INHIBITIONS
Sigmund Freud (1926-27). ‘Inhibitions, Symptoms, Anxiety,’ On Psychopathology,
translated by James Strachey and edited by Angela Richards (London: Penguin
Books), pp. 237-241.
The terms ‘inhibitions, symptoms, and anxiety’ crop up often in clinical work.
Since these technical terms are also used in everyday life, it is important to unpack
what Sigmund Freud meant by using these terms.
These clinical notes summarize the first chapter of ‘Inhibitions, Symptoms, Anxiety’
in which Freud defines the scope of the term ‘inhibition.’
Freud starts by differentiating between ‘inhibitions’ and ‘symptoms.’
The importance of doing so relates to the fact that ‘we meet with illnesses in which
we observe the presence of inhibitions but not of symptoms and are curious to know
the reason for this.’
The main difference, according to Freud, is that an inhibition is merely a restriction
of ego function; it does not have any pathological implication.
However, if inhibitions become excessive, it could become a pathology requiring
treatment.
This distinction is worth keeping in mind since the lay-person uses these terms as
though they were the same.
But, as Freud points out, they are not. It is important to use these terms carefully.
In order to substantiate his distinction, Freud picks out the most typical forms of
inhibition in order to analyse the types of neurotic disturbance that characterize
them.

2. 2
Freud starts with the sexual function which is most likely to be disturbed in cases of
psychopathology.
This is not difficult to understand given that psychoanalysis works with a model of
‘the sexual aetiology of the neuroses.’
But, as Freud will go on to demonstrate in this chapter, in a neurosis a number of
vital functions will be affected sooner or later.
There is an important relationship then between the disturbance of the sexual
function and the vital functions.
That is because the vital functions are affected by the fact that the neurotic subject
has consciously or unconsciously started to attribute a sexual meaning to them.
The moment he does so, they take on a symptomatic cast.
They cease to be merely inhibitions – i.e. a lowering of ego functions and become
symptoms that require an interpretation in the analytic situation.
When Freud analyses some of these inhibitions, what he is doing for his readers is
akin to an interpretation of the most typical of inhibitions at the point at which they
take on a symptomatic cast.
Sexual inhibitions include those that pertain to different aspects of the sexual act.
The most important of these inhibitions is ‘psychosexual impotence.’
Psychosexual impotence does not have a basis in the subject’s body or organic
structure, but relates to the fantasies and fears that the neurotic subject has about the
sexual act.
The diagnostic significance of this inhibition cannot be underestimated because if the
patient lacks maturity, it can encompass all aspects of his life.
To be precise, it is not psychosexual impotence itself that is the main problem for the
neurotic subject or the patient; it is how he responds to it that will determine
whether it will remain a temporary inhibition or become a traumatic symptom.
This is one of the most important points ever made in the analytic doctrine.
Freud was fond of stating that if the ‘vita sexualis’ is normal, the patient cannot
become neurotic. Or, even if he does, it will be temporary and not traumatic.
A common fantasy that could lead to psychosexual impotence has been studied by
both analysts and anthropologists. It is termed ‘vagina dentata.’

3. 3
In this fantasy, the patient is afraid of sexually penetrating a woman because he
unconsciously believes that she has teeth in her vagina like she has teeth in her
mouth.
Such a fantasy or fear is related to the similarity that the patient sees unconsciously
between a woman’s lips and her labia.
This similarity triggers off the patient’s ‘castration’ anxiety and he either loses his
erection or is unable to assume an erection when asked to perform.
If patient is only inhibited in sexual matters, it leads to an ‘abridgement of the sexual
act.’
But if the inhibition becomes a symptom, then, even the thought of the sexual act can
become intolerable.
It could lead to feelings of hysterical disgust or culminate in a phobia as a defence
against the sexual act.
Disturbances of the vital functions could also lead to eating disorders.
The neurotic subject invariably eats too much or too little.
Patients sometimes exhibit fears of being poisoned even when there is no
threatening factor in their life to justify the fear.
Another form of inhibition relates to the motor function.
The subject exhibits fear of either walking or walking in certain places which induce
anxiety.
A number of phobias have been identified in this context.
The best known is agoraphobia which could be a defence against sexual temptation
in the outside world.
And, finally, Freud lists the different forms of inhibition at work.
This section of the chapter should be of interest to those applying analytic theory or
clinical insights in the context of management or work psychology.
Inhibitions at work take the form of a loss of ability, loss of interest, and generate
symptoms like ‘fatigue, giddiness, and sickness.’
Hysterical patients may suffer from different forms of paralyses which do not have a
basis in organic structure but are forms of dysfunctional behaviour.

4. 4
Obsessional patients will suffer from distractions related to ‘delays and repetitions’
that cannot be justified in terms of their designated responsibilities.
What all these inhibitions have in common – as out pointed earlier – is that they
constitute a ‘restriction of an ego-function.’
In order to understand the significance of this restriction or inhibition, it is important
to look at it in as specific a way as possible.
Most of these specific instances that Freud analyses reveal that the restriction of the
ego-function is related to the fact that the inhibitions have taken on a ‘sexual
significance’ for the neurotic subject.
The inhibition in performance then protects the neurotic subject’s ego from having a
conflict with the id (which is the locus of the libido in the structural model of the
subject).
If the conflict with the id should come out into the open, the sexual significance of an
inhibition will become known to the subject and lead to a bout of anxiety.
Inhibitions could also be forms of self-punishment. The patient might have fears of
success or happiness.
Most neurotic subjects experience inhibitions in the context of oedipal fantasies
because of fears of retribution from a parent or a parental figure.
That is because they have an unconscious wish to get ahead of their parents.
An inhibition then could be the ego’s response to either the fear of a conflict with the
id or a conflict with the super-ego.
The inhibition, to conclude, protects the ego by restricting the scope of its activities.
It is a way of safely shrinking the ego by minimizing conflicts in everyday life.
SHIVA KUMAR SRINIVASAN