Freud - Complete Works (222 page)

   As I very rarely find myself
undertaking medical treatment, I can report only one example from
my personal experience of a bungled action of a medical kind. There
is a very old lady whom I have been visiting twice a day for some
years. On my morning visit my medical services are limited to two
actions. I put a few drops of eye-lotion into her eye and give her
a morphine injection. Two bottles are always prepared for me: a
blue one with the collyrium and a white one with the morphine
solution. During the two operations my thoughts are no doubt
usually busy with something else; by now I have performed them so
often that my attention behaves as if it were at liberty. One
morning I noticed that the automaton had worked wrong. I had put
the dropper into the white bottle instead of the blue one and had
put morphine into the eye instead of collyrium. I was greatly
frightened and then reassured myself by reflecting that a few drops
of a two per cent solution of morphine could not do any harm even
in the conjunctival sac. The feeling of fright must obviously have
come from another source.

The Psychopathology Of Everyday Life

1258

   In attempting to analyse this
small mistake I first thought of the phrase ‘sich an der
Alten vergreifen’,¹ which provided a short cut to the
solution. I was under the influence of a dream which had been told
me by a young man the previous evening and the content of which
could only point to sexual intercourse with his own mother.²
The strange fact that the legend finds nothing objectionable in
Queen Jocasta’s age seemed to me to fit in well with the
conclusion that in being in love with one’s own mother one is
never concerned with her as she is in the present but with her
youthful mnemic image carried over from one’s childhood. Such
incongruities always appear when a phantasy that fluctuates between
two periods is made conscious and so becomes definitely attached to
one of the two periods. While absorbed in thoughts of this kind I
came to my patient, who is over ninety, and I must have been on the
way to grasping the universal human application of the Oedipus myth
as correlated with the Fate which is revealed in the oracles; for
at that point I did violence to or committed a blunder on
‘the old woman’. Here again the bungled action was a
harmless one; of the two possible errors, using the morphine
solution for the eye or the eye lotion for the injection, I had
chosen by far the more harmless one. This still leaves the question
open of whether we may admit the possibility of an unconscious
intention in mistakes that can cause serious harm, in the same way
as in the cases which I have discussed.

   Here then my material leaves me
in the lurch, as might be expected, and I have to fall back on
conjectures and inferences. It is well known that in the severer
cases of psychoneurosis instances of self-injury are occasionally
found as symptoms and that in such cases suicide can never be ruled
out as a possible outcome of the psychical conflict. I have now
learnt and can prove from convincing examples that many apparently
accidental injuries that happen to such patients are really
instances of self-injury. What happens is that an impulse to
self-punishment, which is constantly on the watch and which
normally finds expression in self-reproach or contributes to the
formation of a symptom, takes ingenious advantage of an external
situation that chance happens to offer, or lends assistance to that
situation until the desired injurious effect is brought about. Such
occurrences are by no means uncommon in cases even of moderate
severity, and they betray the part which the unconscious intention
plays by a number of special features - e. g by the striking
composure that the patients retain in what is supposed to be an
accident.³

  
¹
[‘To do violence to the old
woman.’ The German word ‘
vergreifen
’ means
both ‘to make a blunder’ and ‘to commit an
assault’.]

  
²
The ‘Oedipus dream’, as I am in
the habit of calling it, because it contains the key to the
understanding of the legend of King Oedipus. In the text of
Sophocles a reference to such a dream is put into Jocasta’s
mouth. Cf.
The Interpretation of Dreams
(1900
a
),
p. 739 ff.
.

  
³
In the present state of our civilization
self-injury which does not have total self-destruction as its aim
has no other choice whatever than to hide itself behind something
accidental or to manifest itself by imitating the onset of a
spontaneous illness. Formerly self-injury was a customary sign of
mourning; at other periods it could express trends towards piety
and renunciation of the world.

The Psychopathology Of Everyday Life

1259

   Instead of a number of cases I
will give a detailed report of only a single example from my
medical experience. A young married woman broke her leg below the
knee in a carriage accident, so that she was bed-ridden for weeks;
what was striking was the absence of any expressions of pain and
the calmness with which she bore her misfortune. This accident
introduced a long and severe neurotic illness of which she was
finally cured by psycho-analysis. In treating her I learnt of the
circumstances surrounding the accident and of certain events that
had preceded it. The young woman was staying with her very jealous
husband on the estate of a married sister, in company with her
numerous other sisters and brothers with their husbands and wives.
One evening in this intimate circle she showed off one of her
accomplishments: she gave an accurate performance of the can-can,
which was received with hearty applause by her relatives but with
scanty satisfaction by her husband, who afterwards whispered to
her: ‘Carrying on like a tart again!’ The remark struck
home - we will not enquire whether it was only on account of the
dancing display. She spent a restless night. Next morning she felt
a desire to go for a drive. She selected the horses herself,
refusing one pair and asking for another. Her youngest sister
wanted her baby and its nurse to go in the carriage with her; my
patient vigorously opposed this. During the drive she showed signs
of nerves; she warned the coachman that the horses were growing
skittish, and when the restless animals were really causing a
moment’s difficulty she jumped out in a fright and broke her
leg, while the others who stayed in the carriage were unharmed.
Although after learning these details we can hardly remain in doubt
that this accident was really contrived, we cannot fail to admire
the skill which forced chance to mete out a punishment that fitted
the crime so well. For it had now been made impossible for her to
dance the can-can for quite a long time.

The Psychopathology Of Everyday Life

1260

   As regards self-injuries of my
own, there is little that I can report in uneventful times; but in
extraordinary circumstances I find that I am not incapable of them.
When a member of my family complains to me of having bitten his
tongue, pinched a finger, or the like, he does not get the sympathy
he hopes for, but instead the question: ‘Why did you do
that?’ I myself once gave my thumb a most painful pinch when
a youthful patient told me during the hour of treatment of his
intention (not of course to be taken seriously) of marrying my
eldest daughter. I knew that at the time she was lying critically
ill in a sanatorium.

   One of my boys, whose lively
temperament used to make it difficult to nurse him when he was ill,
had a fit of anger one day because he was ordered to spend the
morning in bed, and threatened to kill himself, a possibility that
was familiar to him from the newspapers. In the evening he showed
me a swelling on one side of his chest which he had got by bumping
against a door-handle. To my ironical question as to why he had
done it and what he meant by it, the eleven-year-old child answered
as though it had suddenly dawned on him: ‘That was my attempt
at suicide that I threatened this morning.’ I do not think,
by the way, that my views on self-injury were accessible to my
children at the time.

   Anyone who believes in the
occurrence of half-intentional self-
injury
- if I may use a
clumsy expression - will be prepared also to assume that in
addition to consciously intentional suicide there is such a thing
as half-intentional self-
destruction
(self-destruction with
an unconscious intention), capable of making skilful use of a
threat to life and of disguising it as a chance mishap. There is no
need to think such self-destruction rare. For the trend to
self-destruction is present to a certain degree in very many more
human beings than those in whom it is carried out; self-injuries
are as a rule a compromise between this instinct and the forces
that are still working against it, and even where suicide actually
results, the inclination to suicide will have been present for a
long time before in lesser strength or in the form of an
unconscious and suppressed trend.

The Psychopathology Of Everyday Life

1261

   Even a
conscious
intention
of committing suicide chooses its time, means and opportunity; and
it is quite in keeping with this that an
unconscious
intention should wait for a precipitating occasion which can take
over a part of the causation and, by engaging the subject’s
defensive forces, can liberate the intention from their
pressure.¹ The views I am putting forward here are far from
being idle ones. I have learned of more than one apparently chance
mishap (on horseback or in a carriage) the details of which justify
a suspicion that suicide was unconsciously allowed to come about.
For example, an officer, riding in a race with some
fellow-officers, fell from his horse and was so severely injured
that he died some days later. His behaviour on regaining
consciousness was striking in some ways; and his previous behaviour
had been even more remarkable. He had been deeply depressed by the
death of his beloved mother, had had fits of sobbing in the company
of his fellow officers, and to his trusted friends had spoken of
being weary of life. He had wanted to leave the service to take
part in a war in Africa which had not interested him
previously;² formerly a dashing rider, he now avoided riding
whenever possible. Finally, before the race, from which he could
not withdraw, he expressed gloomy forebodings; with the view that
we hold in these matters, it will not remain a surprise to us that
these forebodings turned out to be justified. I shall be told that
it is not to be wondered at if a person in such a state of nervous
depression cannot manage a horse as well as on normal days. I quite
agree; but the mechanism of the motor inhibition produced by this
state of ‘nerves’ should, I think, be looked for in the
intention of self-destruction that I am insisting on.

  
¹
After all, the case is no different from
that of a sexual assault upon a woman, where the man’s attack
cannot be repelled by her full muscular strength because a portion
of her unconscious impulses meets the attack with encouragement. It
is said, as we know, that a situation of this kind
paralyses
a woman’s strength; all we need do is to add the reasons for
this paralysis. To that extent the ingenious judgement delivered by
Sancho Panza as governor of his island is psychologically unjust
(
Don Quixote
, Part 2, Chapter 45). A woman dragged a man
before the judge alleging he had robbed her of her honour by
violence. In compensation Sancho gave her a full purse of money
which he took from the accused; but after the woman’s
departure he gave him permission to pursue her and snatch his purse
back again from her. The two returned struggling, the woman priding
herself on the fact that the villain had not been able to take the
purse from her. Thereupon Sancho declared: ‘If you had
defended your honour with half the determination with which you
have defended this purse, the man could not have robbed you of
it.’

  
²
It is evident that conditions on a field of
battle are such as to come to the help of a conscious intention to
commit suicide which nevertheless shuns the direct way. Compare the
words of the Swedish captain concerning the death of Max
Piccolomini in
Wallensteins Tod
: ‘They say he wanted
to die.’

The Psychopathology Of Everyday Life

1262

   S. Ferenczi of Budapest has
handed over to me for publication the analysis of an ostensibly
accidental injury by shooting, which he explains as an unconscious
attempt at suicide. I can only declare my agreement with his view
of the matter:

   ‘J. Ad., twenty-two years
old, a journeyman carpenter, consulted me on January 18, 1908. He
wanted to find out from me whether the bullet that penetrated his
left temple on March 20, 1907 could or should be removed by
operation. Apart from occasional, not too severe, headaches he felt
perfectly well, and the objective examination revealed nothing at
all apart from the characteristic powder-blackened bullet scar on
the left temple, so I advised against an operation. When asked
about the circumstances of the case he explained that he had
injured himself accidentally. He was playing with his
brother’s revolver,
thought it was not loaded
, pressed
it with his left hand against his
left
temple (he is not
left-handed,) put his finger on the trigger and the shot went off.
There were three bullets in the six-shooter
. I asked him how
the idea of taking up the revolver came to him. He replied that it
was the time of his medical examination for military service; the
evening before, he took the weapon with him to the inn because he
was afraid of brawls. At the examination he was found unfit because
of varicose veins; he was very ashamed of this. He went home and
played with the revolver, but had no intention of hurting him self
- and then the accident happened. When questioned further whether
he was otherwise satisfied with life, he sighed in answer and told
the story of his love for a girl who also loved him but left him
all the same. She emigrated to America simply out of desire for
money. He wanted to follow her, but his parents prevented him. His
sweetheart left on January 20, 1907; two months, that is, before
the accident. In spite of all these suspicious factors the patient
stuck to his point that the shooting was an "accident". I
was however firmly convinced that his negligence in failing to make
sure the weapon was not loaded before playing with it, as well as
his self-inflicted injury, were psychically determined. He was
still labouring under the depressing effects of his unhappy love
affair and obviously wanted to "forget it all" in the
army. When he was deprived of this hope as well, he took to playing
with the revolver - i. e. to an unconscious attempt at suicide. His
holding the revolver in his left and not his right hand is strong
evidence that he was really only "playing" - that is,
that he did not consciously wish to commit suicide.’