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THE PSYCHICAL EFFECTS OF INTOXICATION:

ATTEMPT AT A PSYCHO-ANALYTICAL THEORY OF DRUG·
ADDICTION
BY
SANDOR RADO
BERLIN

Intoxicants are substances of the most varied origin and of a chemical

character (alkaloids, substances of the alcohol group, etc.) which, if
absorbed occasionally or habitually, produce effects of a narcotic,
stimulating and intoxicating nature in mental life. Pharmacology
has more or less throughly investigated the influence of these substances
on our somatic and psychical organic functions, so that we know their
specific effects according to the use made of them and the amount of.
the dose. This information, however, only holds good as an average
(statistical) computation; it cannot be said with certainty beforehand
how a particplar person in a particular case will react to the absorption
of a poisonous substance. Pharmacology takes this state of affairs
into account by assuming a • constitutional factor'; according to
Lewin 1 each individual has his own • toxic equation " the composi-
tion of which, however, is completely unknown, nor does it admit of
further investigation by the pharmacologist.
Daily experienceshews us how great is this uncertainty just in the
matter of the specific effects of intoxicants. Many people are reduced
to a state of intoxication by quite a small amount of alcohol; others
will drink a lot and actually succumb to the physical effectsof intoxica-
tion, and yet remain sober. Indeed the behaviour of one and the
same person can in the course of time alter fundamentally in this
respect without our knowing why. One observes similar phenomena
when administering morphine and other narcotic medicines. It is
the view of psychiatrists that this unknown factor-the individual
predisposition or tendency to intoxication-plays the decisive part in
the retiology of drug-taking and kindred states.
Let us try to penetrate this obscure territory from the point of
view of psycho-analysis. Pharmacology classifies the various effects
of intoxication from its own standpoint. We aim at a psychological
(to be more exact, a metapsychological) survey of the question. and
ask: what are the superior qualities of these substances by virtue of
1 Lewin, Phantastica : die betaubenden und evregenden Genussmittel.

Berlin, 1924, S. 15
3°1
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30 2 SANDOR RAD6

which they are made use of both therapeutically and in ordinary life?
The answer is simple: they offer man help and pleasure in his troubles.
And the t help' may be of two kinds; it is obtained (a) by the analgesic
(sedative, hypnotic) and (b) by the stimulating effect of the drugs.
Hitherto the means by which these effects are attained have not
been investigated analytically. Let us ·see what can be said about
their character at a first approach.
(a) In order to discuss the alleviating effect of the so-called ' anal-
gesics ' we must go into the problem of pain in general. According to
Freud's 2 view, which has provided a sure foundation for the psycho-
logical conception of this difficult question, the specific discomfort of
bodily pain arises when something breaks through the peripheral
barrier against stimuli, thus causing continuous excitations to flow
from the place affected to the central mental apparatus. Through
the failure of the protective barrier the pain, even when it comes from
without, acquires the qualities of the continuous internal stimuli, of
the instincts, that is to say, against which the arrangements for warding
off the stimuli are powerless from the start. In the mental apparatus
the pleasure-pain regulation which holds sway there causes the on-
coming mass of excitation to be bound by the setting up of anti-cathexes
and to be discharged by means of motor actions. The success of
these defensive processes in overcoming pain is dependent on quantita-
tive factors. Experience shows that once a certain intensity of pain-
excitation has been reached mental life succumbs to it without defence.
The biological purpose of pain, to give warning of a threatening
danger, a fails completely at this point.
Now it is easy to see that by reducing or abolishing the sensation
of pain drugs provide just what the mental organization lacks, an
internal barrier against stimuli. This artificial barrier functions
centrally at the sensory openings into the mental apparatus, as if it
were a secondary defence zone. The somatic process which conditions
it invariably consists of diminishing the function through paralysing
the sensitive nerve substance, a method therefore which is used on
occasion even by the natural peripheral protective barrier.s

J Beyond the Pleasure Principle, p. 30.

8 Goldscheider, Das Schmel'zproblem. Berlin,
1920, S. 81.
In local aneesthesia the action of the peripheral protective-barrier is
4

intensified to the point where the receptive function is completely elimi-

nated owing to paralysis of the sensory terminal apparatus.
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THE PSYCHICAL EFFECTS OF INTOXICATION 303

Physicians are agreed that our most valuable analgesic would still
appear to be morphine, although the chemical industry. works hard
to establish ever new specifically effective compounds. L. Levy 6
has recently published one of the few psycho-analytical observations
on this subject. He reports that in a series of severe organic cases
where morphine was successfully administered he was able to observe
a remarkable phenomenon: in their phantasies the patients projected
their serious condition on to persons in their environment. In con-
nection with our problem we should attach considerable theoretical
importance to this discovery of Levy's. As is well known, Freud has
traced the origin of projection to the impulse to treat internal excita-
tions ' as though they were acting not from within but from without,
in order for it to be possible to apply against them the defensive
measures of the barrier against stimuli.t Now if, as we suppose,·
morphine analgesiais an artificial internal barrier, then Levy's observa-
tion supplies a direct experimental proof of the close connection
between protective barrier and projection.
The overcoming of sleeplessness by means of sleep-promoting
remedies or the toxic induction of sleep (narcosis) do not at present
admit of closer analytical description, because we know almost nothing
about the particulars of these conditions. If one considers that
sleeplessness depends on the refractoriness of internal disturbing
stimuli, which neither obey the wish for sleep nor share in the general
withdrawal of cathexis, then one may assume that even in the sleep-
bringing (and sedative) effect of drugs the setting up of an internal
protective barrier plays a part. But with narcosis the psychological
situation certainly goes beyond this.
(b) The specific effect of the stimulants is the one best known to
us and of the most general significance, since these substances are part
of our daily food in the shape of beverages (coffee, tea, etc.). Never-
theless we come up against great difficulties in the attempt to under-
stand psychologically the processes of stimulation. It is clear that
the common statement that stimulants have an invigorating effect on
our intellectual functions is of little service to us. We know from
pharmacology that, strictly speaking, there are no pure stimulants,
since these substances affect the different nerve-centres electively,
partly stimulating and partly paralysing them. Perhaps the only

6 Internationale Zeitschrift fur Psychoanalyse, Bd. X, 1924, S. 434.

• Beyond the Pleasure Principle, p. 33.
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SANDOR RADO

exception is caffeine, with its almost exclusively stimulating effect,

nor is this succeeded by a paralytic phase. We must assume that the
influenceof these substances on the individual brain-centres and func-
tions is very much more extensive and delicately graded in its electivity
than pharmacology is able to demonstrate to-day. For psychological
observation shows us that the psychical effect of these substances is
composed of the interplay of stimulating and paralysing influences.
We perceivethat these substances produce in us feelings of tension and
at the same time remove existing tensions, the final result thus being
, a transformation of painful tensions into pleasurable ones, Unfor-
tunately the value of this simple statement is diminished by the fact
that we know so little of these two kinds of tension.
On the other hand we must not underestimate the importance of
the established fact that a toxic strengthening of our ego-functions is
connected with the change in the feeling-tone of our internal tensions.
Behind this fact lie concealed the economic assumptions concerning
our ego-functions in general, and it is possible that we may find here
the path that will lead to their discovery. Let us consider the situa-
tion where the ego resorts to a toxic strengthening of its functions.
We have already said that the ego stands in need of this help in its
difficulties, in the hard fight it wages to maintain its existence. Freud
has impressively described for us 'the subordinate relationships of
the ego'.7 The ego must be for ever vigilantly adapting itself to
satisfy the demands of reality and at the same time to do justice to its
two internal taskmasters-the libido of the id and the demands of
conscience. Introspection showsthat the libidinal instinctual tensions,
as well as the conscience-tensions (the so-called sense of guilt), con-
stantly manifest themselves in consciousness, even if only as a vague
uneasiness, when the ego succeeds in holding at a distance the ideas
connected with them or when these are from the outset incapable of
becoming conscious. Similarly one sees that the Ucs gratification-
phantasies of the libidinal object-instincts and of the self-satisfied
ideal (super-ego) become manifest in consciousness in the form of an
indefinite feeling of pleasure [good-bumourr.s Sometimes one sue-
ceeds in catching such Ues products in analysis, and then one can see
how stimulants bring about the psychical change 'of mood. They
create a free path for intentions which have been interrupted by
7 The Ego and the Id, p. 68.
8 These facts must also play an important part in the effect which
music has on our mental life.
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THE PSYCHICAL EFFECTS OF INTOXICATION 305

decoying the disturbing (inhibiting) influences (chiefly conscience-

tensions) with Des gratification and so clearing them out of the way.
It appears that over and above this the function directing the intention
experiences a directly strengthening influence; whereupon an approach
of instinctual sources otherwise cut off would be made possible by an
extensive connection between the ego-contents and the symbol-
cathexes of the id, or a partial transition, dependent on this, from the
fixed course of the secondary process to the primary process. The
essential part of this action takes place in the system Pcs; the rigid
fetters of this system are relaxed, its 'transmission-resistances'
diminished. We observe that in the processes of stimulation there
really takes place a successful sexualization of the ego-functions.
* * * *
The second way in which drugs manifest their effect is in the pro-
duction of pleasurable states (euphoria, narcosis, intoxication), the
intensity and quality of which varies very widely. The variety of the
phenomena under consideration is increased to an extraordinary degree
by the special qualities and secondary effects of particular drugs, by
the way in which they are used as well as by the varied disturbances in
the individual's capacity for reaction. Let us choose from this the
type of what may be called ' perfect' effect, as we have it more or
less in a successful morphine euphoria or in a blissful opium intoxica-
tion. The erotic character of these states-which was long ago pointed
out by Abraham-is immediately evident. But this suggestion can be
pursued much further, and we are then obliged to aver that there is
an essential similarity between an ideal form of intoxication and the
terminal pleasure of natural sexual enjoyment, the orgasm. The
decisive characteristic of the genital orgasm, which entitles it to be
considered a gratification sui generis, can only reside in the fact that
the orgastic feeling of sensual pleasure rapidly loses its originally local
character and affects the whole organism most intensely in a manner
which baffies closer investigation.t This is never the case with
gratifications of the erotic component-instincts, and with the ordinary
sensations of pleasure in the erotogenic zones; their local colouring
remains during the whole course of the excitation, which-so far as
our present knowledge reaches-is not capable of general diffusion.
But it is precisely this trait which recurs in a very marked form in the
a The diffusion of the orgastic excitation over the whole vegetative
nervous system has already been investigated physiologically. Cf. L. R.
Muller, Das vegetative Neruensystem, Berlin, 1920.
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SANDOR RADQ
clinical picture of intoxication. We feel ourselves justified, therefore,
in describing the induction of this kind of pleasure as the orgastic effect
of intoxicants. In comparison with the steep curve of the genital
orgasm, the pharmacotoxic or pharmacogenic orgasm presents as a
rule an extended course; we shall come back again to this striking
difference in the two phenomena.
One must now ask whether this conception of the orgastic effect
of intoxicants may be extended from the ' perfect' type of effect to
all others also. The capacity of particular drugs and of different indi-
viduals in achieving this effect certainly differs very much; but
observation has left hardly a doubt that in every case the process
tends to have this outcome. To be practical we must of course take
into account every grade of intensity, nor must we be led astray by
those cases in which the orgastic effect is qualitatively atrophied or
completely wanting.· For that matter, the genital orgasm as well is
often enough subject to similar disturbances. Even the condition of
, stimulation " which on theoretical grounds we distinguish so sharply
from pure pleasure-states, proves in the light of this knowledge to be a
most successfully effected ' minimal dose ' of orgastic sensation.
In the pharmacogenic orgasm the individual becomes acquainted
with a new kind of erotic gratification, which enters into rivalry with
the natural modes of sexual gratification. It is characterized by quite
unusual advantages, and the more the normal possibilities of gratifica-
tion are interfered with by neurosis or unfavourable circumstances the
more alluring it must appear. The decisive turning-point occurs
when the ego takes up its stand on the desire for intoxication, and so
brings the whole of its libidinal capacity to meet the experience of
the pharmacotoxic orgasm. Once intoxication has become the sexual
aim of the individual he has fallen a victim to the craving, and it is
only seldom that anyone succeeds in preventing it from developing
further. In this connection it makes hardly any difference whether
he deliberately gave way to the temptation or whether his first vivid
experience of the pleasure of intoxication was made on the occasionof
a medical application of the dru~. Only too often we may observe an
instructive initial phase in which the patient denies to himself his
desire for intoxication; he continues to make use of the drug as
medicine, to combat his suffering. to strengthen his capacities, or to
increase his potency-but in reality he has long been subject to its
orgastic effect and has turned away from the ' reality-principle' into
the dangerous region of a blind obedience to the instincts.
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THE PSYCHICAL EFFECTS OF INTOXICATION 307

On the other hand we now see why it is that sometimes taking an

intoxicant leads neither to intoxication or to orgastic relief of tension:
first and foremost because the longing for it, the desire for intoxication,
is wanting. And, further, in place of the desire for intoxication an
intense inhibition-in the form of prudence or a reaction of con-
science-may occur, which fetters the libidinal transformations and
thereby prevents the occurrence of intoxication even with a consider-
able dose.
Addiction to pharmacotoxic gratification is accompanied by
decisive results for the entire psychical and somatic condition of the
person concerned. In view of the great variety of the states resulting
from drug-addiction which come under clinical observation, this com-
pressed review of the subject must be confined to the consideration
of some of its principal characteristics. The main scene of the trans-
formations is of course the libido, for erotic gratification by means of
drugs constitutes a violent attack on our biological sexual organiza-
tion, a bold advance on the part of our' anaplastic' culture. Let us
confine ourselves to indulgence' in morphine and the very , modern '
way of imbibing the drug by means of the Pravaz syringe. To put
it briefly, this method cuts out the whole peripheral sexual apparatus
and causes the exciting stimuli to affect the central organ directly
like a short circuit. I propose that this state of affairs. which deserves
a name to call attention to it, should be described as • meta-erotism.P
With the advance in organic chemistry, the manufacture of the most
exquisitely pleasurable (sexual) substances is surely only a question
of time, and it is easy to prophesy that this mode of gratification will
playa part as yet incalculable in the future of the human race.
The elimination of the genital and of the other erotogenic zones,
with their complex interplay, and the slow course of their excitation
first undermines genital potency and then rapidly leads to a turning
away from the-now uninteresting-real love-subjects. Morphine,
like most intoxicants, is a dangerous potency poison, which rapidly
assumes a monopoly as the source of pleasure. Along with the
abandonment of sexual love there begins a weakening of the relations
10 I prefer this expression to the obvious' para-erotism,' which is more

appropriately reserved as the scientific designation of the perversions.

The many terminological proposals made in this essay should be justified
by the circumstance that in it I have attempted to consider an extensive
range of facts which has not so far been thoroughly investigated ana-
lytically.
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SANDOR RAD6

to reality, of course with the exception of the drug itself; the whole
interest of the patient becomes then gradually concentrated on the
procuring of it.
But meta-erotism not only destroys genital potency, it also reduces
the value of all other natural means of obtaining pleasure and replaces
them by the pharamacotoxic orgasm as the instrument of gratification.
We have to conceive of the pharmacogenic orgasm as an executive
process which effects a discharge for the entire psychosexual excitation
in much the same way as onanism does in the child.
Now what form does the libido take, psychically considered, after
the real love-objects and genital activity have been given up? As
always, when genital primacy goes under the pre-genital organizations
come into their own. An extensive regression re-activates the erotic
strivings of infancy; the (Edipus complex breaks out anew, and it
depends in the first place on the vicissitudes of the infantile history
and the fixation-points of the libido which impulses and wish-phan-
tasies then come to the fore. Daydreams and phantasies entirely
comparable to onanistic phantasies begin to be produced, of which the
excitation is then discharged in the pharmacotoxic orgasm. In the
blissful phantasies of the opium-eater, as writers have described them,
there clearly occur even wish-fulfilling hallucinations. Every hidden
source of pleasure which can contribute to increase the intoxication
may thus add its share to the gratification. Even the genital libido,
after its withdrawal from reality, may be retained for a while in phan-
tasy-as an excitation belonging to the (Epidus complex-and
becomes manifest in the symbolic value attached to the syringe, etc..
In many cases the significance of particular erotogenic zones is so
strong that they as it were save their lives by passing over into the
meta-erotic regime; they can then be retained as places and means
of applying the drug, and take their place with their specific excitation
or symbol-cathexis as a kind of fore-pleasure mechanism in the meta-
erotic organization. In this respect the oral zone, whose intimate
relations to intoxicants are familiar, has an unrivalled position. Cer-
tainly drunkenness was the earliest form of drug-taking, and it is still
perhaps the most widely distributed. Broadly speaking, there is
hardly an available part of the body which might not be used for the
assimilation of the poison, and the various ways of applying it are also
astonishingly numerous.
If one ventures to compare artificial meta-erotism with the natural
organizations of the libido, then some further points may be gained
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THE PSYCHICAL EFFECTS OF INTOXICATION 309

which in the confusing abundance of the phenomena serve to illuminate

our survey. One then sees clearly that the phannacogenic orgasm may
be subject to just as many disturbances and produce just as many
pathological reactions-of a second order, so to speak-as a normal
process in life. First and foremost, on account of its great practical
importance in respect of the curability of an addict, we have the
phenomenon of incapacity to obtain a pharmacotoxic orgasm when
it is desired as a pleasure-Pharmacotoxic impotence. It seems prema-
ture to give at this time a picture of the psychical instinctual forces
and processes which can produce this condition-and on occasioneven
in the initial stages of the illness. In any case we must particularly
emphasize the fact that with most poisons for physiological reasons
(' habituation ') this incapacity sooner or later necessarily supervenes,
nor can it be overcome even by the most desperate efforts on the part
of the patient. Another group of phenomena is presented to us by
the results, familiar to us in the theory of the neuroses, of an unsuccess-
ful attempt at defence or a severe reaction of conscience. This defence
completely spoils or frustrates the intended phannacogenic orgasm, but
it is directed against its psychical superstructure. against the for-
bidden impulses of the CEdipus complex. which have been re-activated
by the meta-erotism. Thus as the neurotic reverse side of blissful
intoxication one meets with the most frightful anxiety-conditions,
torturing excitations, horrible visions, etc. In this connection the par-
ticular poisons behave very variously. With many drugs (e.g. cocaine)
the specific action is from the start complicated by such phenomena.
Only thorough analyses can give us insight into all these conditions, as
into the great adjoining territory of the manifestations accompanying
deprivation of the drug, which we cannot deal with here.
The appearance of the more primitive libido-organizations in the
clinical picture of drug-taking has already been mentioned by several
authors. Lately Schilder 11 in particular has emphasized this point.
In this connection it remains to be said that the destruction of genital
primacy may intensify certain pregenital erotisms to such an extent
that on occasion-especially in a period of deprivation-manifest
perversions occur. A large part is played here by homosexuality" in
particular, the relations of which to alcoholism were described long
ago by Abraham, and to cocainism some time ago by Hartmann. I 2
11 Schilder, Enturur] zu einer Psychiatric auf psychoanalytischer Grund-

lage, Internationaler Psychoanalytischer Verlag, 1925.

12 Hartmann, • Kokainismus und Homosexualitat.' Zeitschrift fur die
gesamte Psychologie und Neurologic, 1925.
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310 SANDOR RADQ

In severecases of addiction the disintegrating effectof meta-erotism

on mental life is still more extensive. One gets the impression that
through the neglect of their somatic sources even the specifically
psychical excitations of the component-instincts gradually succumb;
indeed, that in general all the differentiated mental expressions of
erotism, with their manifold and closely inter-related varieties of
content, progressively decay. An irresistible processof mental atrophy
seizes and annihilates everything which the psychogenesis of the indi-
vidual has created: a mental state which can only be compared to
certain final phasesofschizophrenia. It wouldbe entirely in accordance
with what actually happens' if one were to construct theoretically a
final phase in which the libido lost all its genetically differentiated
characteristics and forms of organization. appearing in mental life
only as an amorphous erotic tension. The form of this mental life can
then be expressed in a very simple formula: desire for intoxication-
intoxication-after-effects of intoxication, etc. This hypostasis seems
to me to throw much light on certain severe forms of addiction, for it
is indisputable that if • habituation' does not cause incapacity for
intoxication in time, they tend towards a final result of this nature.
The whole mental personality then, if one only includes the drug as
part of it, represents an auto-erotic pleasure-apparatus. The ego is
completely subjugated and devastated by the libido of the id-one
might almost say transformed back into the id; the outer world is
ignored, and the conscience is disintegrated. One gleans from this
some idea of the enormousimportance of the drug as the only interest-
ing pieceof reality and it becomes intelligiblethat sometimes from the
very beginning of his affliction the patient disregards every considera-
tion of justice and morality in his efforts to procure it.
The consideration of a factor we have hitherto neglected will add
some further points to our survey. The progressiveprocess of regres-
sion and decay which ensues in the libido on meta-erotism must
according to Freud's view, which has been confirmed by all our ex-
periences of the psychoneuroses, be accompanied by an extensive
instinctual defusion and liberation of the destructive components. It
is easy to show that the facts completely bear out this theoretical
expectation. The above-mentioned destruction of the higher mental
organizations and differentiations can only be the work of the destruc-
tive components liberated by the defusion, and it is still unknown
what share this psychical factor has in the somatic degeneration of the
drug-taker, which goes along with his mental decay. Asecond foot-
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THE PSYCHICAL EFFECTS OF INTOXICATION 311

hold for the unchained destructive tendencies is offered by the institu-

tion of conscience within the super-ego whose aggressive impulses-
in Freud's sense-work upon the ego as a ' conscience instinct' .13 With
many drug patients-we don't yet know which-one must actually
assume a rapid heightening of the Des conscience-tension, which then
amongst other things also experiencesan intense need for punishment.
This state of affairs results in a vicious circle which drives the addict
ever deeper into the craving and provides a psychological foundation
for the inevitable increase of the dose.
Now although the aggressive tendencies, especially with certain
drugs, can be directed outwards in various way, without doubt their
greatest significance lies in their t turning upon the self'. A remark-
able analogy: the addict is destroyed by the (psychical) disintegrating
results of his meta-erotism, just as many lower animals are through
their natural sexual functioning.
• • • •
We will now turn to what is perhaps the most important question
that arises out of these considerations. What sort of person is it who
passes beyond the boundary between • help' and • pleasure' when
first taking drugs for medicinal purposes, or else who deliberately
resorts to it straightaway with a view to pleasure? 1& In other

13 It seems advantageous to describe the dynamic manifestations of the

conscience institution as a • conscience instinct.' According to Freud's

views the conscience instinct represents phylogenetically the latest diffe-
rentiation in human instinctual life, and it is determined chiefly by its
topographical point of attack. This manner of speech allows us to employ
both appropriately and usefully in the psychology of the ego expressions
familiar to us from the theory of the instincts.
14 The accompanying table should make clearer what I have said

above.
The Psychical Effects of Intoxication
(A) Help
(a) Internal barrier against stimuli (analgeSiC,} I
. , nterru:1 re1"1'.1'
~eJ oJ t e
h
sedative, hypnotic, narcotic effects).
, , ego m sn tthee sertnce
serui oJ,I'
(b) Strengthening of the ego functions (stimu- I'
, l'ea ity,
lating effects).
(B) Pleasure
Subj ugation of the ego
by the id. Destruc-
Pharmacotoxic orgasm (intoxicating effects) ti
wn oJ,I' ~its l'e1at'~ons
{
to l'eality
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3I2 SANDOR RAD6

words, what sort of person is it who develops the desire fOT intoxication
and then follows the path that leads to addiction to drugs?
The most common factor met with in the retiology of drug-taking
is of course real frustation, accompanied by all the manifold
phenomena familiar to us from theretiology of the neuroses. One
finds nothing which would not be met with as an • actual conflict • in
the neuroses also, particularly since in addicts all the neuroses are
found as an retiological factor. The frustration is frequently followed
first by a neurosis and only afterwards by the drug-habit, which com-
plicates the situation by only one degree. Therefore the predisposing
factors which determine the choice of a • flight into drug-addiction'
must lie further back, and our whole endeavour to bring this sphere
of phenomena within the premisses of Freud's libido-theory leads us
to place them in the libidinal development of the individual. Thus
our attention was directed to oral erotism whose retiologicalsignificance
for intoxication, already mentioned by Freud in the DreiAbhandlungen
zur Sexuauheorie, has been confirmed by all later analytic experience.
The surprising fact emerged that the psychical expressions of oral
erotism are also strongly marked in all cases of addiction where the
drug is not assimilated by the mouth at all. One got the impression
that secret links exist between the oral zone and the bliss of intoxica-
tion, whose significance remains unaltered even when other erotogenic
zones have taken the place of the oral zone for purposes of assimilating
the drug, or when any connecti?n with erotogenic zones is entirely
dispensed with. In cases of the latter kind, where use is made of the
Pravaz syringe, one perhaps sees this most clearly. It is as though
intoxication had remained an oral phenomenon, although precisely
this refined way of producing it has emancipated it from the oral zone.
This view is certainly unsatisfactory and becomes still more so when
one considers how little has been gained by it. Abraham's classic
researches have shown us how varied are the effects and manifestations
of oral erotism in our mental life, so that at first one really does not
know what it is in oral erotism that disposes to intoxication, when the
oral erotogenic zone is excluded from any part in producing the latter.
I confess that for years this problem had defeated me until some
chance observations at last presented me with the solution. Curiously
enough, they were not in the first place connected with drug-addicts
at all. One day I got the idea that the somatic source of the excita-
tions of oral erotism might not be confined to the mouth area. Plenti-
ful and enjoyable assimilation of good food is followed by a phase
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THE PSYCHICAL EFFECTS OF INTOXICATION 3I3

which physiologically can only correspond to the onset of digestion

and absorption, and in which psychically the picture is dominated
by the pleasant feeling of satiety and, over and above this, by a gene-
rally diffused feeling of sensual pleasure in which again the whole
organismparticipates. 15 Manypeoplepossess the capacity for enjoying
this phenomenon intensely, with many others it has been more or less
lost. There is no doubt that in the adult this process represents the
vestiges of a fundamental psycho-physiological function which one
must describe as an • alimentary orgasm'. It must be shown else-
where by means of casuistic material what significance this orgastic
mode of gratification can acquire in normal life and in certain neuroses;
such observations are easy to make if one's attention has already been
directed to the phenomenon. We must hasten to consider this dis-
covery theoretically.
It is only too clear that the oral organization of the suckling
culminates in the alimentary orgasm. Since the somatic processes
which lie at the base of this orgastic pleasure are hidden inside the body
and so cannot be perceived by the infant, its interest is bound to be
displaced on to the palpable oral zone, the excitation of which initiates
the gratification-process as a forepleasure mechanism. One may
assume that the infant who sucks for pleasure is really striving for a
repetition of the orgastic gratification and contents itself with the
enjoyment confined to the oral zone merely as a substitute. Owing
to the dependence of the alimentary orga.sm on nutrition a repetition
of it is only possible at all within the limits allowed by the physical
state of the digestion tracts at the moment. Thus an enhanced erotic
value of the oral zone would derive from the alimentary orgasm. But
in any case a lively anticipation remains deeply impressed on the Ucs
that by stimulating the oral zone that particular secret and mysterious
pleasure might be repeated. It may even have been this which led
one of our orally inclined ancestors first to discover a plant with
intoxicating properties.
The alimentary orgasm makes its appearance in mental life as a
mature psycho-physiological mechanism, and with its ramifications
influences psychosexual development to a considerable extent. With
its cathexes it is concerned in a whole series of infantile ideas and

16 The digestive phase, as is well known, is distinguished by a series of

physiological signs (rise of temperature, alteration of the state of the blood,

etc.) which relate to the organism as a whole.
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SANDOR RAD6

wishes familiar to us; thus, to name only the most important, it

proves to be the real keystone of the combination: oral impregnation
-abdominal pregnancy-anal birth. These connections can be
proved with certainty during analysis and belong to the most im-
portant factual foundations of our point of view; it is only the
inference about the suckling that is a speculative-even if forcibly
obvious-addition. But we must wait till we have proceeded further
before we can explain why the genital type of thoughts inherent in
the infantile sexual theories' which are so significant for the symp-
I

tomatology of the neuroses is in the first place anchored about the

alimentary orgasm as its centre. I will only remark at this point
that, given the constitutional factor in question, the sexual excitation
produced by such phantasies-belonging to the <Edipus complex-
may be discharged by means of the alimentary orgasm and not by
onanism. Thus, when the mental defences against the now forbidden
incestuous trends are set up, this process affects the executive function
of the alimentary orgasm, and in this way gives rise to the psychical
disturbances of nutrition (distaste for food, stomach and bowel
neuroses, etc.) with which we are familiar.
It is in the alimentary orgasm, with its psychical superstructure
just described, that we shall find the specific fixation-point which
produces the disposition to drug-addiction. The pharmacotoxic
orgasm proves to be a new edition of the alimentary, with which it
has in common its extended course and much besides, but which
otherwise in its pleasurable qualities it far outstrips.P Thus is solved
at one stroke a whole series of questions which arise out of the study
of drug-addiction. The pregenital erotisms prominent in the clinical
pictures of the disease are the psychical guise of the alimentary
orgasm of infancy. We are provided with an ingenious psychological
motivation for the prevalence of homosexuality, without being driven
to accept Schilder's hypothesis (loc. cit.) of the mutual affinity between
particular drugs and erotisms. And then we at last understand from
the psychological angle why most of these cravings are accompanied
by considerable emaciation and neglect of nourishment, why, according
to a statement of Lewin's (loc. cit., p. 70), with the coca-chewer, for
example, 'though insufficiently nourished the body does not ex-
18 There is a long series of nutrients and pleasure-giving delicacies and

substances, which form a continuous transition beginning with the ordinary

substances of nourishment and ending with pure intoxicants, so that we
have to take into account combinations of the two orgastic functions.
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THE PSYCHICAL EFFECTS OF INTOXICATION 315

perience feelings of hunger for a considerable period'. The vast scale
of the pharmacotoxic orgasm has swallowed up the rudiments of the
alimentary orgasm which acts as a pleasure premium to ensure
nutrition and digestion.
On the other hand, we cannot ascribe to the Ucs conscience-
tension (sense of guilt) any specific part in the retiology of drug-taking.
Its importance in severe cases of addiction is much the same as in
severe cases of neurosis. Its presence alone-however important this
may be practically-cannot explain why a person should particularly
succumb to a neurosis or fall a victim to the drug habit, or else become
a criminal or an unusually beneficent philanthropist.
We cannot leave our theme without making a short comparative
survey of what we have discovered about orgastic modes of gratifica-
tion. In this connection the phylogenetic approach seems an enticing
one. If one is not going to assume what seems hardly credible, that
in the ascending scale of animal life the orgastic mode of gratification
appeared on the scene as a novelty only with the development of the
generative organ, then for purely evolutionary reasons one is driven
to the view that the alimentary constitutes the original form of
orgasm; hence in primitive animate beings the highest pleasure
function is combined with their most important self-preservative
function.P Thus in the suckling period ontogenesis repeats the
formation of that phase of development, only to leave it-and this
again is surely only a repetition from phylogenesis (beasts of prey !)-
for a time in a state of fierce rivalry with the maturing genital phase.is
This must also be the explanation of the fact that in ontogenesis the
complex of ' genital' phantasies-and often, too, the discharge of the
sexual excitation belonging to them-attaches in the first place to the

I? From biological considerations we must assume the existence of the

alimentary orgasm in even the lowest of the protista, which assimilate

nourishment with their entire undifferentiated cellular system. The con-
ception of the orgasm as a • fundamental erotic function ' and of the cell
as an 'orgastic unity' opens out an interesting biological perspective,
which may illuminate the processes of cell-division and copulation from a
new angle and make them accessible to experimental research.
18 The oral zone seems to act as intermediary in the transition from the

alimentary orgasm to genital erotism; on the relations between the oral

and genital phases see the works of Helene Deutsch, Psychologic dey
weiblichen Sexualfwnktionen ; Bernfeld, Psychologie des Saiiglings.. and
Rank, ZUY Genese dey Genitalitd»,
21
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316 SANDOR RADO

alimentary orgasm. The physiologico-chemical processes of digestion
and absorption must lie at the base of the alimentary orgasm. We
assume in accordance with Freud's conception of sexual chemistry 18
that in these processes a conversion-perhaps also a formation-e-of
sexual substances takes place. Thus the alimentary orgasm would be
an (endo-jtoxic phenomenon, closely bound up with the nutritional
processes. If one follows Ferenczi's 10 views on this subject, according
to which one must conceiveof the evolution of the genital stage in the
progressivedifferentiation processof phylogenesisas the establishment
and isolation of an erotic centre, whose function it should be to release
the processes of self-preservation from their erotic bondage, then one
may add that from our point of view the genital has clearly won away
the orgastic effect from the nutritional process. In spite of its subjec-
tion to the reproductive function, genitality certainly has a greater
freedom in the handling of sexual substances than was the case with
the nutritional act. How it has succeeded in converting the toxic
sexual substances into the new genital explosive orgasm, one cannot
in the meantime understand. But by discovering the pharmacotoxic
orgasm man has played a trick on biology. He also has in this way
imitated the nutritional function and has raised its sexual-toxic
accompanying phenomena, set free from their unwieldy alimentary
functioning, to the position of an independent orgastic mode of gratifi-
cation. It may be that some day the pharmacogenic orgasm will
succeed in imitating the genital.
It is common to all three forms of orgasm that by equalizing the
erotic tensions they induce sleep; in the alimentary orgasm the freed
destructive tendencies (chiefly in the form of chemical aggression) are
directed against the nourishment assimilated, in the genital and
pharmacogenic orgasms-much less obviously in the former than the
latter-actually against the body itself.
And now, to end with, I will say something about melancholia.
It is to be expected from the great importance of the oral incorporative
function in this illness that the alimentary orgasm will help to shed
some new light on its pathology. We will confine ourselves here to
some brief suggestions. The resemblance between mania and melan-
cholia, on the one hand, and intoxication and its depressing after-

U Drei Abhandlungen zur Sexualtheorie, 1905.

10 Versuch einer Genitaltheorie, Intemationaler Psychoanalytischer
Bibliothek, No. XIV, 1924.
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THE PSYCHICAL EFFECTS OF INTOXICATION 317

effects on the other, is well known. And I think that we can now
point out the biological prototypes of both pairs of phenomena;
i.e. the alimentary orgasm and a long-continued state of hunger which
has already become paralysing. When the sufferer from hunger
destroys his own bodyin order to meet his needfor energy,hisaggression
in the long run is directed against former objects of the outer world
which he had incorporated and built into his own being. Without
overestimating the importance of such analogies, it is nevertheless
surprising to observehow faithfully melancholiarepeats these processes
in the purely psychical sphere. And, further, one must not forget that
rapid emaciation is one of the obvious clinical accompaniments of
melancholia. But even the frequent complaint of melancholies that
their bodies are disintegrating, that they have lost their stomach,
their intestines, etc., betrays its deep biological meaning, a serious·
disturbance in the orgastic alimentary function. And finally we must
note the relevancy of the fact that with our animal ancestors, and
frequently even now with the suckling, an alimentary orgasm follows
directly upon a torturing condition of hunger, just as mania follows on
melancholia.
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