Freud - Complete Works (254 page)

Fragment Of An Analysis Of A Case Of Hysteria

1435

   At this point a certain suspicion
of mine became a certainty. The use of ‘
Bahnhof
’
[‘station’; literally,
‘railway-court’]¹ and
‘
Friedhof
’ [‘cemetery’; literally,
‘peace-court’] to represent the female genitals was
striking enough in itself, but it also served to direct my awakened
curiosity to the similarly formed ‘
Vorhof
’
[‘vestibulum’; literally, ‘fore-court’] -
an anatomical term for a particular region of the female genitals.
This might have been no more than mistaken ingenuity. But now, with
the addition of ‘nymphs’ visible in the background of a
‘thick wood’, no further doubts could be entertained.
Here was a symbolic geography of sex!  ‘Nymphae’,
as is known to physicians though not to laymen (and even by the
former the term is not very commonly used), is the name given to
the labia minora, which lie in the background of the ‘thick
wood’ of the pubic hair. But any one who employed such
technical names as ‘vestibulum’ and
‘nymphae’ must have derived his knowledge from books,
and not from popular ones either, but from anatomical text-books or
from an encyclopaedia - the common refuge of youth when it is
devoured by sexual curiosity. If this interpretation were correct,
therefore, there lay concealed behind the first situation in the
dream a phantasy of defloration, the phantasy of a man seeking to
force an entrance into the female genitals.²

  
¹
Moreover, a ‘station’ is used
for purposes of ‘
Verkehr
’
[‘traffic’, intercourse’, ‘sexual
intercourse’]: this fact determines the psychical coating in
a number of cases of railway phobia.

  
²
The phantasy of defloration formed the
second component of the situation. The emphasis upon the difficulty
of getting forward and the anxiety felt in the dream indicated the
stress which the dreamer was so ready to lay upon her virginity - a
point alluded to in another place by means of the Sistine Madonna.
These sexual thoughts gave an unconscious ground-colouring to the
wishes (which were perhaps merely kept secret ) concerned with the
suitor who was waiting for her in Germany. We have already
recognized the phantasy of revenge as the first component of the
same situation in the dream. The two components do not coincide
completely, but only in part. We shall subsequently come upon the
traces of a third and still more important train of
thought.

Fragment Of An Analysis Of A Case Of Hysteria

1436

   I informed Dora of the
conclusions I had reached. The impression made upon her must have
been forcible, for there immediately appeared a piece of the dream
which had been forgotten:
she went calmly to her room, and began
reading a big book that lay on her writing table
.¹ The
emphasis here was upon the two details ‘calmly’ and
‘big’ in connection with ‘book’. I asked
whether the book was in encyclopaedia
format
, and she said
it was. Now children never read about forbidden subjects in an
encyclopaedia
calmly
. They do it in fear and trembling, with
an uneasy look over their shoulder to see if some one may not be
coming. Parents are very much in the way while reading of this kind
is going on. But this uncomfortable situation had been radically
improved, thanks to the dream’s power of fulfilling wishes.
Dora’s father was dead, and the others had already gone to
the cemetery. She might calmly read whatever she chose. Did not
this mean that one of her motives for revenge was a revolt against
her parents’ constraint? If her father was dead she could
read or love as she pleased.

   At first she would not remember
ever having read anything in an encyclopaedia; but she then
admitted that a recollection of an occasion of the kind did occur
to her, though it was of an innocent enough nature. At the time
when the aunt she was so fond of had been so seriously ill and it
had already been settled that Dora was to go to Vienna, a
letter
had come from another uncle, to say that they could
not go to Vienna, as a boy of his, a cousin of Dora’s
therefore, had fallen dangerously ill with appendicitis. Dora had
thereupon looked up in the encyclopaedia to see what the symptoms
of appendicitis were. From what she had then read she still
recollected the characteristic localization of the abdominal
pain.

  
¹ On another occasion, instead of
‘calmly’ she said ‘not the least sadly’ (
p. 1430 
n
.
) - I can quote
this dream as fresh evidence for the correctness of an assertion
made in my
Interpretation of Dreams
(Chapter VII, Section A;
p. 953
) to the effect that
those pieces of a dream which are at first forgotten and are only
subsequently remembered are invariably the most important from the
point of view of understanding the dream. In the same place I went
on to the conclusion that the forgetting of dreams must also be
explained as an effect of endopsychic resistance.

Fragment Of An Analysis Of A Case Of Hysteria

1437

   I then remembered that shortly
after her aunt’s death Dora had had an attack of what had
been alleged to be appendicitis. Up till then I had not ventured to
count that illness among her hysterical productions. She told me
that during the first few days she had had high fever and had felt
the pain in her abdomen that she had read about in the
encyclopaedia. She had been given cold fomentations but had not
been able to bear them. On the second day her period had set in,
accompanied by violent pains. (Since her health had been bad, the
periods had been very irregular.) At that time she used to suffer
continually from constipation.

   It was not really possible to
regard this state as a purely hysterical one. Although hysterical
fever does undoubtedly occur, yet it seemed too arbitrary to put
down the fever accompanying this questionable illness to hysteria
instead of to some organic cause operative at the time. I was on
the point of abandoning the track, when she herself helped me along
it by producing her last addendum to the dream:
she saw herself
particularly distinctly going up the stairs
.

   I naturally required a special
determinant for this. Dora objected that she would anyhow have had
to go upstairs if she had wanted to get to her flat, which was on
an upper floor. It was easy to brush aside this objection (which
was probably not very seriously intended) by pointing out that if
she had been able to travel in her dream from the unknown town to
Vienna without making a railway journey she ought also to have been
able to leave out a flight of stairs. She then proceeded to relate
that after the appendicitis she had not been able to walk properly
and had dragged her right foot. This state of things had continued
for a long time, and on that account she had been particularly glad
to avoid stairs. Even now her foot sometimes dragged. The doctors
whom she had consulted at her father’s desire had been very
much astonished at this most unusual after-effect of an
appendicitis, especially as the abdominal pains had not recurred
and did not in any way accompany the dragging of the
foot.¹

  
¹
We must assume the existence of some
somatic connection between the painful abdominal sensations known
as ‘ovarian neuralgia’ and locomotor disturbances in
the leg on the same side; and we must suppose that in Dora’s
case the somatic connection had been given an interpretation of a
particularly specialized sort, that is to say, that it had been
overlaid with and brought into the service of a particular
psychological meaning. The reader is referred to my analogous
remarks in connection with the analysis of Dora’s symptom of
coughing and with the relation between catarrh and loss of
appetite.

Fragment Of An Analysis Of A Case Of Hysteria

1438

   Here, then, we have a true
hysterical symptom. The fever may have been organically determined
- perhaps by one of those very frequent attacks of influenza that
are not localized in any particular part of the body. Nevertheless
it was now established that the neurosis had seized upon this
chance event and made use of it for an utterance of its own. Dora
had therefore given herself an illness which she had read up about
in the encyclopaedia, and she had punished herself for dipping into
its pages. But she was forced to recognize that the punishment
could not possibly apply to her reading the innocent article in
question. It must have been inflicted as the result of a process of
displacement, after another occasion of more guilty reading had
become associated with this one; and the guilty occasion must lie
concealed in her memory behind the contemporaneous innocent
one.¹ It might still be possible, perhaps, to discover the
nature of the subjects she had read about on that other
occasion.

   What, then, was the meaning of
this condition, of this attempted simulation of a
perityphlitis?  The remainder of the disorder, the dragging of
one leg, was entirely out of keeping with perityphlitis. It must,
no doubt, fit in better with the secret and possibly sexual meaning
of the clinical picture; and if it were elucidated might in its
turn throw light on the meaning which we were in search of. I
looked about for a method of approaching the puzzle. Periods of
time had been mentioned in the dream; and time is assuredly never a
matter of indifference in any biological event. I therefore asked
Dora when this attack of appendicitis had taken place; whether it
had been before or after the scene by the lake. Every difficulty
was resolved at a single blow by her prompt reply: ‘Nine
months later.’ The period of time is sufficiently
characteristic. Her supposed attack of appendicitis had thus
enabled the patient with the modest means at her disposal (the
pains and the menstrual flow) to realize a phantasy of
childbirth
.² Dora was naturally aware of the
significance of this period of time, and could not dispute the
probability of her having, on the occasion under discussion, read
up in the encyclopaedia about pregnancy and childbirth. But what
was all this about her dragging her leg? I could now hazard a
guess. That is how people walk when they have twisted a foot. So
she had made a ‘false step’: which was true indeed if
she could give birth to a child nine months after the scene by the
lake. But there was still another requirement upon the fulfilment
of which I had to insist. I am convinced that a symptom of this
kind can only arise where it has an
infantile
prototype. All
my experience hitherto has led me to hold firmly to the view that
recollections derived from the impressions of later years do not
possess sufficient force to enable them to establish themselves as
symptoms. I scarcely dared hope that Dora would provide me with the
material that I wanted from her childhood, for the fact is that I
am not yet in a position to assert the general validity of this
rule, much as I should like to be able to do so. But in this case
there came an immediate confirmation of it. Yes, said Dora, once
when she was a child she had twisted the same foot; she had slipped
on one of the steps as she was going
downstairs
. The foot -
and it was actually the same one that she afterwards dragged - had
swelled up and had to be bandaged and she had had to lie up for
some weeks. This had been a short time before the attack of nervous
asthma in her eighth year.

  
¹
This is quite a typical example of the way
in which symptoms arise from exciting causes which appear to be
entirely unconnected with sexuality.

  
²
I have already indicated that the majority
of hysterical symptoms, when they have attained their full pitch of
development, represent an imagined situation of sexual life - such
as a scene of sexual intercourse, pregnancy, childbirth,
confinement, etc.

Fragment Of An Analysis Of A Case Of Hysteria

1439

   The next thing to do was to turn
to account our knowledge of the existence of this phantasy:
‘If it is true that you were delivered of a child nine months
after the scene by the lake, and that you are going about to this
very day carrying the consequences of your false step with you,
then it follows that in your unconscious you must have regretted
the upshot of the scene. In your unconscious thoughts, that is to
say, you have made an emendation in it. The assumption that
underlies your phantasy of childbirth is that on that occasion
something took place,¹ that on that occasion you experienced
and went through everything that you were in fact obliged to pick
up later on from the encyclopaedia. So you see that your love for
Herr K. did not come to an end with the scene, but that (as I
maintained) it has persisted down to the present day - though it is
true that you are unconscious of it.’ - And Dora disputed the
fact no longer.²

  
¹
The phantasy of defloration is thus found
to have an application to Herr K., and we begin to see why this
part of the dream contained material taken from the scene by the
lake - the refusal, two and a half hours, the wood, the invitation
to L--.

  
²
I may here add a few supplementary
interpretations to those that have already been given: The
‘
Madonna
’ was obviously Dora herself; in the
first place because of the ‘adorer’ who had sent her
the pictures, in the second place because she had won Herr
K.’s love chiefly by the motherliness she had shown towards
his children, and lastly because she had had a child though she was
still a girl (this being a direct allusion to the phantasy of
childbirth). Moreover, the notion of the ‘Madonna’ is a
favourite counter-idea in the mind of girls who feel themselves
oppressed by imputations of sexual guilt, - which was the case with
Dora. A first suspicion of this connection came to me while I was
working as a physician at the Psychiatric Clinic of the University.
I there came across a case of confusional insanity with
hallucinations, in which the attack, which ran a rapid course,
turned out to be a reaction to a reproach made against the patient
by her
fiancé
. - If the analysis had been continued,
Dora’s maternal longing for a child would probably have been
revealed as an obscure though powerful motive in her behaviour. The
numerous questions which she had been raising latterly seem to have
been belated derivatives of questions inspired by the sexual
curiosity which she had tried to gratify with the encyclopaedia.
The subjects which she read up in it were presumably pregnancy,
childbirth, virginity, and so on. - In reproducing the dream Dora
had forgotten one of the questions which need to be inserted into
the course of the second situation in the dream. This question
could only be; ‘Does Herr -- live here?’ or
‘Where does Herr -- live?’ There must have been some
reason for her having forgotten this apparently innocent question,
especially as she need not have brought it into the dream at all.
This reason, it seems to me, lay in her surname itself, which also
denoted an object and in fact more than one kind of object, and
which could therefore be regarded as an ‘ambiguous’
word. Unluckily I cannot give the name and show how well designed
it was to indicate something ‘ambiguous’ and
‘improper’. This interpretation was supported by the
discovery of a similar play upon words in another part of the
dream, where the material was derived from Dora’s
recollections of her aunt’s death (‘they have already
gone to the cemetery’) and where there was similarly a play
upon her aunt’s
name
. These improper words seemed to
point to a second and
oral
source of information, since the
encyclopaedia would not cover them. I should not have been
surprised to hear that this source had been Frau K. herself,
Dora’s calumniator. In that case she would have been the one
person whom Dora generously spared, while she pursued the others
with an almost malignant vindictiveness. Behind the almost
limitless series of displacements which were thus brought to light,
it was possible to divine the operation of a single simple factor -
Dora’s deep-rooted homosexual love for Frau K.