But other members of this group of wish-fulfillments, _e.g._, the
hysterical symptoms, evince one essential quality which I have so far
failed to find in the dream. Thus, from the investigations frequently
referred to in this treatise, I know that the formation of an hysterical
symptom necessitates the combination of both streams of our psychic
life. The symptom is not merely the expression of a realized
unconscious wish, but it must be joined by another wish from the
foreconscious which is fulfilled by the same symptom; so that the
symptom is at least doubly determined, once by each one of the
conflicting systems. Just as in the dream, there is no limit to further
over-determination. The determination not derived from the Unc. is, as
far as I can see, invariably a stream of thought in reaction against the
unconscious wish, _e.g._, a self-punishment. Hence I may say, in
general, that _an hysterical symptom originates only where two
contrasting wish-fulfillments, having their source in different psychic
systems, are able to combine in one expression_. (Compare my latest
formulation of the origin of the hysterical symptoms in a treatise
published by the _Zeitschrift für Sexualwissenschaft_, by Hirschfeld and
others, 1908). Examples on this point would prove of little value, as
nothing but a complete unveiling of the complication in question would
carry conviction. I therefore content myself with the mere assertion,
and will cite an example, not for conviction but for explication. The
hysterical vomiting of a female patient proved, on the one hand, to be
the realization of an unconscious fancy from the time of puberty, that
she might be continuously pregnant and have a multitude of children,
and this was subsequently united with the wish that she might have them
from as many men as possible. Against this immoderate wish there arose a
powerful defensive impulse. But as the vomiting might spoil the
patient's figure and beauty, so that she would not find favor in the
eyes of mankind, the symptom was therefore in keeping with her punitive