If the register of hypochondria as a possible reading mode for the exposed cases prompts to interrogate its nature and at the same time induces to question the register of ACTUALITY that it belongs to, we must first of all probably clarify what Freud said about it. The difficulty and ambiguity of such a reminder, however, must be reported, as an effect and even a reflection of the contradictions and flaws inherent in his conception of actual neuroses, conception linked to a theory which, proposing among other functions to consider and develop the important issue of somatizations, presents a two-dimension model based on the opposition of neurotic and actual. Described by M. Sami-Ali as bi-dimensional, it consists in admitting that, in contrast to psychoneurotic symptoms that invariably refer to repression, to the failure of repression and to the return of the repressed, possibly through somatic expression, the symptoms of actual neuroses (hypochondria, anxiety neurosis, neurasthenia) result, with no mediation, of possible disturbances of the sexual metabolism whose decrease or unbridled increase they reflect, with no signification. Freud said it very variously evoking them in the form of

intracranial pressure, sensations of pain, a state of irritation in an organ, weakening or inhibition of a function (Freud 1916–1917, p.387)

that are meaningless symptoms. More exactly, unlike the primary meaning of psychoneurotic symptoms, they may only have a secondary meaning, acquired after the fact, that does not trigger the process of symptomatic formation, and this keeps them away from any symbolism of causal type. Even if Graves’ disease, invoked by Freud himself in support of his remarks, may mean a guilt being atone, it is nonetheless true that, from the point of view of causation, it is due to

toxins which are not introduced into the body from outside but originate in the subject’s own metabolism (Freud 1916–1917, p.388).

Guilt is then an attempt to rationalize a state of hormonal disorder whose true etiology is in another sphere. Therefore, actual symptoms are, for Freud, entirely physical.

They are not only manifested in the body (as are hysterical symptoms, for instance, as well), but they are also themselves entirely somatic processes, in the generating of which all the complicated mental mechanisms we have come to know are absent (Freud 1916–1917, p.387).

And if, despite this fact, they are within the Freudian corpus, it is thanks to the energy concept of libido which brings together actual and neurotic in the sexual function which is not a,

purely psychical thing any more than it is a somatic one (Freud 1916–1917, p.388).

The evocation of these indications however allows to point out that if the psychosomatic disorders are quite conceivable from the analytical perspective because of their compliance with the described neuroses as referring to actuality, the allocation, maintained by Freud throughout his life, of the original cause of these to the disorders of actual sexual life appears, on the other hand little appropriate in the light of current psychoanalytic thought.

The question arises then about how to articulate actual and neurotic, and about what is indeed specific in the register of actuality, related first of all by Freud to actualized sexual practices, justifying that it could be qualified so. In fact, if we consider terminology, the word “actual” has a chronological meaning, neuroses designed as actual primarily resulting from disorders of the sexuality lived currently: “actual”, on this point, only equals “contemporary”. You might also think that by some sort of contiguity, “actual” in this context means something close to “manifest” in the sense that Freud frequently opposed it to the term “latent”. Strictly asemic because of their total corporeality, actual neuroses do indeed hide no cryptic content needing an anamnestic investigation to be appreciated. Finally “actual”, with a real semantic ambiguity, refers to the Act in a pluralist way. In this regard, J. Laplanche and J. B. Pontalis noted moreover that the verb Agieren (translated by acting out, turning into Act)

has an ambiguity which is in Freud’s thought itself: he confuses what, in transference, is actualization and what resorts to driving action, which is not necessarily implied by transference (Laplanche and Pontalis 1967, p.240).

Similarly, in the field of actual neuroses, a reference to driving action is involved, that Freud described as “inadequate” or even “diverted” (Freud 1973b, p.33). More importantly, in a quite basal way, the actual symptom here is equivalent to the action and discharge which constitute the normal coitus (Freud 1973b, p.35). What matters here is indeed sexual intercourse: actual neuroses would so be, strictly speaking, disorders of sexuality as an act, that this is expressed, with no distinction, by an inadequate discharge of drive or an equivalent that is nonexplicitly driving the action. From these different interpretations, ranging beyond contradictions, emerges the essential idea of a body sex-endowed before even being a sexual body, which clearly refers to the register of actuality as a necessary and fundamental anchor. Archaicity and actuality both refer to the sex-endowed body, while the neurotic level, more elaborate and more psychological, refers to the symbolic body, in a gradation that is much more topical than chronological. Archaic zones which are “not neurotized”, mysterious reflections of the biological body, can very well be anchored within subjects with neurotic traits. This coexistence must be highlighted as, besides it applies to the mentioned cases, it enables to think the register of actuality and the one of neurosis as synchronic more than diachronic concepts.

The various notations that Freud devoted in particular to the very point of hypochondria, also have, by many sides, these imperfections and contradictions already identified in his theory about the context of actual neuroses. The first difficulty lies in that, throughout his reflection, the classic distinction between major or psychotic hypochondria and minor or neurotic hypochondria does never retain his attention, joining in this a clinical tradition for which, even when it is “simple” and “minor”, hypochondria thought as a single actual neurosis is always somewhat seen as “vesanic”. This very important and heavy ambiguity is visible, and not without effects, in the three citations selected here to show how Freud deals with the subject and taken from his study of the Schreber case (1911), from On Narcissism: an Introduction. (1914) and from Introductory Lectures on Psycho–Analysis (1916)

This had already been noted by Morel who stated that delusions of persecution were ultimately only a transformation of hypochondria. And Magnan, considering the “chronic delusion” during its so-called “incubation” phase, writes the same way:

At this stage of the disease, it really looks like hypochondria (Magnan and Sérieux 1890, p.43).

In his “psychoanalytic study of a case of paranoia”, it is however the interesting question of the instance of hypochondria in it that Freud, resorting to analogy, asks, without answering it in precise terms. Yet we can see him expose some parts of his theory, pointing in his remarks, among other elements, the famous “detachment of libido”:

the liberated libido becomes attached to the ego, and is used for the aggrandizement of the ego (Freud 1911, p.72).

But this “fixation at the stage of narcissism” is only mentioned to report, in fact, the delusions of grandeur, while its affinity with hypochondria is, in some way, not really developed.