Freud - Complete Works (366 page)

   ² The patient subsequently
admitted that this scene probably occurred one or two years
later.

Notes Upon A Case Of Obsessional Neurosis

2132

   ‘When I was six years old I
already suffered from erections, and I know that once I went to my
mother to complain about them. I know too that in doing so I had
some misgivings to get over, for I had a feeling that there was
some connection between this subject and my ideas and
inquisitiveness, and at that time I used to have a morbid idea
that my parents knew my thoughts; I explained this to myself by
supposing that I had spoken them out loud, without having heard
myself do it
. I look on this as the beginning of my illness.
There were certain people, girls, who pleased me very much, and I
had a very strong wish
to see them naked
. But in wishing
this I had
an uncanny feeling, as though something must happen
if I thought such things, and as though I must do all sorts of
things to prevent it
.’

   (In reply to a question he gave
an example of these fears: ‘For instance,
that my father
might die
.’) ‘Thoughts about my father’s
death occupied my mind from a very early age and for a long period
of time, and greatly depressed me.’

   At this point I learnt with
astonishment that the patient’s father, with whom his
obsessional fears were, after all, occupied
now
, had died
several years previously.

Notes Upon A Case Of Obsessional Neurosis

2133

   The events in his sixth or
seventh year which the patient described in the first hour of his
treatment were not merely, as he supposed, the beginning of his
illness, but were already the illness itself. It was a complete
obsessional neurosis, wanting in no essential element, at once the
nucleus and the prototype of the later disorder, - an elementary
organism, as it were, the study of which could alone enable us to
obtain a grasp of the complicated organization of his subsequent
illness. The child, as we have seen, was under the domination of a
component of the sexual instinct, the desire to look, as a result
of which there was a constant recurrence in him of a very intense
wish connected with persons of the female sex who pleased him - the
wish, that is, to see them naked. This wish corresponds to the
later obsessional or compulsive idea; and if the quality of
compulsion was not yet present in the wish, this was because the
ego had not yet placed itself in complete opposition to it and did
not yet regard it as something foreign to itself. Nevertheless,
opposition to this wish from some source or other was already in
activity, for its occurrence was regularly accompanied by a
distressing affect.¹ A conflict was evidently in progress in
the mind of this young libertine. Side by side with the obsessive
wish, and intimately associated with it, was an obsessive fear:
every time he had a wish of this kind he could not help fearing
that something dreadful would happen. This something dreadful was
already clothed in a characteristic indeterminateness which was
thenceforward to be an invariable feature of every manifestation of
the neurosis. But in a child it is not hard to discover what it is
that is veiled behind an indeterminateness of this kind. If the
patient can once be induced to give a particular instance in place
of the vague generalities which characterize an obsessional
neurosis, it may be confidently assumed that the instance is the
original and actual thing which has tried to hide itself behind the
generalization. Our present patient’s obsessive fear,
therefore, when restored to its original meaning, would run as
follows: ‘If I have this wish to see a woman naked, my father
will be bound to die.’ The distressing affect was distinctly
coloured with a tinge of uncanniness and superstition, and was
already beginning to give rise to impulses to do something to ward
off the impending evil. These impulses were subsequently to develop
into the
protective measures
which the patient adopted.

  
¹
Yet attempts have been made to explain
obsessions without taking the affects into account!

Notes Upon A Case Of Obsessional Neurosis

2134

   We find, accordingly: an erotic
instinct and a revolt against it; a wish which has not yet become
compulsive and, struggling against it, a fear which is already
compulsive; a distressing affect and an impulsion towards the
performance of defensive acts. The inventory of the neurosis has
reached its full muster. Indeed, something more is present, namely,
a kind of
delusion
or
delirium
with the strange
content that his parents knew his thoughts because he spoke them
out loud without his hearing himself do it. We shall not go far
astray if we suppose that in making this attempt at an explanation
the child had some inkling of those remarkable mental processes
which we describe as unconscious and which we cannot dispense with
if we are to throw any scientific light upon this obscure subject.
‘I speak my thoughts out loud, without hearing them’
sounds like a projection into the external world of our own
hypothesis that he had thoughts without knowing anything about
them; it sounds like an endopsychic perception of what has been
repressed.

   For the situation is clear. This
elementary neurosis of childhood already involved a problem and an
apparent absurdity, like any complicated neurosis of maturity. What
can have been the meaning of the child’s idea that if he had
this lascivious wish his father would be bound to die? Was it sheer
nonsense? Or are there means of understanding the words and of
perceiving them as a necessary consequence of earlier events and
premises?

   If we apply knowledge gained
elsewhere to this case of childhood neurosis, we shall not be able
to avoid a suspicion that in this instance as in others (that is to
say, before the child had reached his sixth year) there had been
conflicts and repressions, which had themselves been overtaken by
amnesia, but had left behind them as a residuum the particular
content of this obsessive fear. Later on we shall learn how far it
is possible for us to rediscover those forgotten experiences or to
reconstruct them with some degree of certainty. In the meantime
stress may be laid on the fact, which is probably more than a mere
coincidence, that the patient’s infantile amnesia ended
precisely with his sixth year.

Notes Upon A Case Of Obsessional Neurosis

2135

   To find a chronic obsessional
neurosis beginning like this in early childhood, with lascivious
wishes of this sort connected with uncanny apprehensions and an
inclination to the performance of defensive acts, is no new thing
to me. I have come across it in a number of other cases. It is
absolutely typical, although probably not the only possible type.
Before proceeding to the events of the second session, I should
like to add one more word on the subject of the patient’s
early sexual experiences. It will hardly be disputed that they may
be described as having been considerable both in themselves and in
their consequences. But it has been the same with the other cases
of obsessional neurosis that I have had the opportunity of
analysing. Such cases, unlike those of hysteria, invariably possess
the characteristic of premature sexual activity. Obsessional
neuroses make it much more obvious than hysterias that the factors
which go to form a psychoneurosis are to be found in the
patient’s
infantile
sexual life and not in his present
one. The current sexual life of an obsessional neurotic may often
appear perfectly normal to a superficial observer; indeed, it
frequently offers to the eye far fewer pathogenic elements and
abnormalities than in the instance we are now considering.

(C)  THE GREAT OBSESSIVE
FEAR

   ‘I think I will begin
to-day with the experience which was the immediate occasion of my
coming to you. It was in August, during the manoeuvres in ---. I
had been suffering before, and tormenting myself with all kinds of
obsessional thoughts, but they had quickly passed off during the
manoeuvres. I was keen to show the regular officers that people
like me had not only learnt a good deal but could stand a good deal
too. One day we started from --- on a short march. During a halt I
lost my pince-nez, and, although I could easily have found them, I
did not want to delay our start, so I gave them up. But I wired to
my opticians in Vienna to send me another pair by the next post.
During that same halt I sat between two officers, one of whom, a
captain with a Czech name, was to be of no small importance to me.
I had a kind of dread of him,
for he was obviously fond of
cruelty
. I do not say he was a bad man, but at the
officers’ mess he had repeatedly defended the introduction of
corporal punishment, so that I had been obliged to disagree with
him very sharply. Well, during this halt we got into conversation,
and the captain told me he had read of a specially horrible
punishment used in the East . . .’

Notes Upon A Case Of Obsessional Neurosis

2136

   Here the patient broke off, got
up from the sofa, and begged me to spare him the recital of the
details. I assured him that I myself had no taste whatever for
cruelty, and certainly had no desire to torment him, but that
naturally I could not grant him something which was beyond my
power. He might just as well ask me to give him the moon. The
overcoming of resistances was a law of the treatment, and on no
consideration could it be dispensed with. (I had explained the idea
of ‘resistance’ to him at the beginning of the hour,
when he told me there was much in himself which he would have to
overcome if he was to relate this experience of his.) I went on to
say that I would do all I could, nevertheless, to guess the full
meaning of any hints he gave me. Was he perhaps thinking of
impalement? - ‘No, not that; . . . the criminal was tied up .
. .’ - he expressed himself so indistinctly that I could not
immediately guess in what position - ‘a pot was turned upside
down on his buttocks . . . some
rats
were put
into it . . . and they . . .’ -
he had again got up, and was showing every sign of horror and
resistance - ‘. . . 
bored their way
in 
. . .’ - Into his anus, I helped him
out.

   At all the more important moments
while he was telling his story his face took on a very strange,
composite expression. I could only interpret it as one of
horror
at pleasure of his own of which he himself was unaware
. He
proceeded with the greatest difficulty: ‘At that moment the
idea flashed through my mind
that this was happening to a person
who was very dear to me
.’¹ In answer to a direct
question he said that it was not he himself who was carrying out
the punishment, but that it was being carried out as it were
impersonally. After a little prompting I learnt that the person to
whom this ‘idea’ of his related was the lady whom he
admired.

  
¹
He said ‘idea’ - the stronger
and more significant term ‘wish’, or rather
‘fear’, having evidently been censored. Unfortunately I
am not able to reproduce the peculiar indeterminateness of all his
remarks.

Notes Upon A Case Of Obsessional Neurosis

2137

   He broke off his story in order
to assure me that these thoughts were entirely foreign and
repugnant to him, and to tell me that everything which had followed
in their train had passed through his mind with the most
extraordinary rapidity. Simultaneously with the idea there always
appeared a ‘sanction’, that is to say, the defensive
measure which he was obliged to adopt in order to prevent the
phantasy from being fulfilled. When the captain had spoken of this
ghastly punishment, he went on, and these ideas had come into his
head, by employing his usual formulas (a ‘but’
accompanied by a gesture of repudiation, and the phrase
‘whatever are you thinking of?’) he had just succeeded
in warding off
both
of them.

   This ‘both’ took me
aback, and it has no doubt also mystified the reader. For so far we
have heard only of one idea - of the rat punishment being carried
out upon the lady. He was now obliged to admit that a second idea
had occurred to him simultaneously, namely, the idea of the
punishment being applied to his father. As his father had died many
years previously, this obsessive fear was much more nonsensical
even than the first, and accordingly it had attempted to escape
being confessed to for a little while longer.

Notes Upon A Case Of Obsessional Neurosis

2138

   That evening, he continued, the
same captain had handed him a packet that had arrived by the post
and had said: ‘Lieutenant A.¹ has paid the charges for
you. You must pay him back.’ The packet had contained the
pince-nez that he had wired for. At that instant, however, a
‘sanction’ had taken shape in his mind, namely,
that
he was not to pay back the money
or it would happen - (that is,
the phantasy about the rats would come true as regards his father
and the lady). And immediately, in accordance with a type of
procedure with which he was familiar, to combat this sanction there
had arisen a command in the shape of a vow: ‘
You must pay
back the 3.80 Kronen to Lieutenant A
.’ He had said these
words to himself almost half aloud.

   Two days later the manoeuvres had
come to an end. He had spent the whole of the intervening time in
efforts at repaying Lieutenant A. the small amount in question; but
a succession of difficulties of an apparently
external
nature had arisen to prevent it. First he had tried to effect the
payment though another officer who had been going to the post
office. But he had been much relieved when this officer brought him
back the money, saying that he had not met Lieutenant A. there, for
this method of fulfilling his vow had not satisfied him, as it did
not correspond with the wording, which ran: ‘
You
must
pay back the money to Lieutenant A.’ Finally, he had met
Lieutenant A., the person he was looking for; but that officer had
refused to accept the money, declaring that he had not paid
anything for him, and had nothing whatever to do with the post,
which was the business of Lieutenant B. This had thrown my patient
into great perplexity, for it meant that he was unable to keep his
vow, since it had been based upon false premises. He had
excogitated a very curious means of getting out of his difficulty,
namely, that he should go to the post office with both the men, A.
and B., that A. should give the young lady there the 3.80
kronen
, that the young lady should give them to B., and that
then he himself should pay back the 3.80
kronen
to A.
according to the wording of his vow.