" The symptoms belonging to this neurosis fall, in general, into two groups, each having an opposite trend. They are either prohibitions, precautions and expiations—that is, negative in character—or they are, on the contrary, substitutive satisfactions which often appear in symbolic disguise. The negative, defensive group of symptoms is the older of the two; but as illness is prolonged, the satisfactions, which scoff at all defensive measures, gain the upper hand. The symptom-formation scores a triumph if it succeeds in combining the prohibition with satisfaction so that what was originally a defensive command or prohibition acquires the significance of a satisfaction as well; and in order to achieve this end it will often make use of the most ingenious associative paths. "

― Sigmund Freud , Inhibitions, Symptoms and Anxiety