Freud - Complete Works (367 page)

  
¹
The names are of little consequence
here.

Notes Upon A Case Of Obsessional Neurosis

2139

   It would not surprise me to hear
that at this point the reader had ceased to be able to follow. For
even the detailed account which the patient gave me of the external
events of these days and of his reactions to them was full of
self-contradictions and sounded hopelessly confused. It was only
when he told the story for the third time that I could get him to
realize its obscurities and could lay bare the errors of memory and
the displacements in which he had become involved. I shall spare
myself the trouble of reproducing these details, the essentials of
which we shall easily be able to pick up later on, and I will only
add that at the end of this second session the patient behaved as
though he were dazed and bewildered. He repeatedly addressed me as
‘Captain’, probably because at the beginning of the
hour I had told him that I myself was not fond of cruelty like
Captain N., and that I had no intention of tormenting him
unnecessarily.

   The only other piece of
information that I obtained from him during this hour was that from
the very first, on all the previous occasions on which he had had a
fear that something would happen to people he loved no less than on
the present one, he had referred the punishments not only to our
present life but also to eternity - to the next world. Up to his
fourteenth or fifteenth year he had been devoutly religious, but
from that time on he had gradually developed into the free-thinker
that he was to-day. He reconciled the contradiction between his
beliefs and his obsessions by saying to himself: ‘What do you
know about the next world? Nothing
can
be known about it.
You’re not risking anything - so do it.’ This form of
argument seemed unobjectionable to a man who was in other respects
particularly clear-headed, and in this way he exploited the
uncertainty of reason in the face of these questions to the benefit
of the religious attitude which he had outgrown.

Notes Upon A Case Of Obsessional Neurosis

2140

   At the third session he completed
his very characteristic story of his efforts at fulfilling his
obsessional vow. That evening the last gathering of officers had
taken place before the end of the manoeuvres. It had fallen to him
to reply to the toast of ‘The Gentlemen of the
Reserve’. He had spoken well, but as if he were in a dream,
for at the back of his mind he was being incessantly tormented by
his vow. He had spent a terrible night. Arguments and
counter-arguments had struggled with one another. The chief
argument, of course, had been that the premise upon which his vow
had been based - that Lieutenant A. had paid the money for him -
had proved to be false. However, he had consoled himself with the
thought that the business was not yet finished, as A. would be
riding with him next morning part of the way to the railway station
at P--, so that he would still have time to ask him the necessary
favour. As a matter of fact he had not done this, and had allowed
A. to go off without him; but he had given instructions to his
orderly to let A. know that he intended to pay him a visit that
afternoon. He himself had reached the station at half-past nine in
the morning. He had deposited his luggage there and had seen to
various things he had to do in the small town, with the intention
of afterwards paying his visit to A. The village in which A. was
stationed was about an hour’s drive from the town of P--. The
railway journey to the place where the post office was would take
three hours. He had calculated, therefore, that the execution of
his complicated plan would just leave him time to catch the evening
train from P--- to Vienna. The ideas that were struggling within
him had been, on the one hand, that he was simply being cowardly
and was obviously only trying to save himself the unpleasantness of
asking A. to make the sacrifice in question and of cutting a
foolish figure before him, and that that was why he was
disregarding his vow; and, on the other hand, that it would, on the
contrary, be cowardly of him to
fulfil
his vow, since he
only wanted to do so in order to be left in peace by his
obsessions. When in the course of his deliberations, the patient
added, he found the arguments so evenly balanced as these, it was
his custom to allow his actions to be decided by chance events as
though by the hand of God. When, therefore, a porter at the station
had addressed him with the words, ‘Ten o’clock train,
sir? ‘ he had answered ‘Yes’, and in fact had
gone off by the ten o’clock train. In this way he had
produced
fait accompli
and felt greatly relieved. He had
proceeded to book a seat for luncheon in the restaurant car. At the
first station they had stopped at it had suddenly struck him that
he still had time to get out, wait for the next down train, travel
back in it to P--, drive to the place where Lieutenant A. was
quartered, from there make the three hours’ train journey
with him to the post office, and so forth. It had only been the
consideration that he had booked his seat for luncheon with the
steward of the restaurant car that had prevented his carrying out
this design. He had not abandoned it, however; he had only put off
getting out until a later stop. In this way he had struggled
through from station to station, till he had reached one at which
it had seemed to him impossible to get out because he had relatives
living there. He had then determined to travel through to Vienna,
to look up his friend there and lay the whole matter before him,
and then, after his friend had made his decision, to catch the
night train back to P--. When I expressed a doubt whether this
would have been feasible, he assured me that he would have had half
an hour to spare between the arrival of the one train and the
departure of the other. When he had arrived in Vienna, however, he
had failed to find his friend at the restaurant at which he had
counted on meeting him, and had not reached his friend’s
house till eleven o’clock at night. He told him the whole
story that very night. His friend had held up his hands in
amazement to think that he could still be in doubt whether he was
suffering from an obsession, and had calmed him down for the night,
so that he had slept excellently. Next morning they had gone
together to the post office, to dispatch the 3.80
kronen
to
the post office at which the packet containing the pince-nez had
arrived.

Notes Upon A Case Of Obsessional Neurosis

2141

   It was this last statement which
provided me with a starting-point from which I could begin
straightening out the various distortions involved in his story.
After his friend had brought him to his senses he had dispatched
the small sum of money in question neither to Lieutenant A. nor to
Lieutenant B., but direct to the post office. He must therefore
have known that he owed the amount of the charges due upon the
packet
to no one but the official at the post office
, and he
must have known this before he started on his journey. It turned
out that in fact he had known it before the captain made his
request and before he himself made his vow; for he now remembered
that a few hours
before
meeting the cruel captain he had had
occasion to introduce himself to another captain, who had told him
how matters actually stood. This officer, on hearing his name, had
told him that he had been at the post office a short time before,
and that the young lady there had asked him whether he knew a
Lieutenant L. (the patient, that is), for whom a packet had
arrived, to be paid for on delivery. The officer had replied that
he did not, but the young lady had been of opinion that she could
trust the unknown lieutenant and had said that in the meantime she
would pay the charges herself. It had been in this way that the
patient had come into possession of the pince-nez he had ordered.
The cruel captain had made a mistake when, as he handed him over
the packet, he had asked him to pay back the 3.80
kronen
to
A., and the patient must have known it was a mistake. In spite of
this he had made a vow founded upon this mistake, a vow that was
bound to be a torment to him. In so doing he had suppressed to
himself, just as in telling the story he had suppressed to me, the
episode of the other captain and the existence of the trusting
young lady at the post office. I must admit that when this
correction has been made his behaviour becomes even more senseless
and unintelligible than before.

   After he had left his friend and
returned to his family his doubts had overtaken him afresh. His
friend’s arguments, he saw, had been no different from his
own, and he was under no delusion that his temporary relief was
attributable to anything more than his friend’s personal
influence. His determination to consult a doctor was woven into his
delirium in the following ingenious manner. He thought he would get
a doctor to give him a certificate to the effect that it was
necessary for him, in order to recover his health, to perform some
such action as he had planned in connection with Lieutenant A.; and
the lieutenant would no doubt let himself be persuaded by the
certificate into accepting the 3.80 crowns from him. The chance
that one of my books happened to fall into his hands just at that
moment directed his choice to me. There was no question of getting
a certificate from me, however; all that he asked of me was, very
reasonably, to be freed of his obsessions. Many months later, when
his resistance was at its height, he once more felt a temptation to
travel to P-- after all, to look up Lieutenant A. and to go through
the farce of returning him the money.

Notes Upon A Case Of Obsessional Neurosis

2142

(D)  INITIATION INTO THE NATURE OF THE
TREATMENT

   The reader must not expect to
hear at once what light I have to throw upon the patient’s
strange and senseless obsessions about the rats. The true technique
of psycho-analysis requires the physician to suppress his curiosity
and leaves the patient complete freedom in choosing the order in
which topics shall succeed each other during the treatment. At the
fourth session, accordingly, I received the patient with the
question: ‘And how do you intend to proceed
to-day?’

   ‘I have decided to tell you
something which I consider most important and which has tormented
me from the very first.’ He then told me at great length the
story of the last illness of his father, who had died of emphysema
nine years previously. One evening, thinking that the condition was
one which would come to a crisis, he had asked the doctor when the
danger could be regarded as over. ‘The evening of the day
after to-morrow’, had been the reply. It had never entered
his head that his father might not survive that limit. At half-past
eleven at night he had lain down for an hour’s rest. He had
woken up at one o’clock, and had been told by a medical
friend that his father had died. He had reproached himself with not
having been present at his death; and the reproach had been
intensified when the nurse told him that his father had spoken his
name once during the last days, and had said to her as she came up
to the bed: ‘Is that Paul?’ He had thought he noticed
that his mother and sisters had been inclined to reproach
themselves in a similar way; but they had never spoken about it. At
first, however, the reproach had not tormented him. For a long time
he had not realized the fact of his father’s death. It had
constantly happened that, when he heard a good joke, he would say
to himself: ‘I must tell Father that.’ His imagination,
too, had been occupied with his father, so that often, when there
was a knock at the door, he would think: ‘Here comes
Father’, and when he walked into a room he would expect to
find his father in it. And although he had never forgotten that his
father was dead, the prospect of seeing a ghostly apparition of
this kind had had no terrors for him; on the contrary, he had
greatly desired it. It had not been until eighteen months later
that the recollection of his neglect had recurred to him and begun
to torment him terribly, so that he had come to treat himself as a
criminal. The occasion of this happening had been the death of an
aunt by marriage and of a visit of condolence that he had paid at
her house. From that time forward he had extended the structure of
his obsessional thoughts so as to include the next world. The
immediate consequence of this development had been that he became
seriously incapacitated from working.¹ He told me that the
only thing that had kept him going at that time had been the
consolation given him by his friend, who had always brushed his
self-reproaches aside on the ground that they were grossly
exaggerated. Hearing this, I took the opportunity of giving him a
first glance at the underlying principles of psycho-analytic
therapy. When there is a
mésalliance
, I began,
between an affect and its ideational content (in this instance,
between the intensity of the self-reproach and the occasion for it
), a layman will say that the affect is too great for the occasion
- that it is exaggerated and that consequently the inference
following from the self-reproach (the inference that the patient is
a criminal) is false. On the contrary, the physician says:
‘No. The affect is justified. The sense of guilt is not in
itself open to further criticism. But it belongs to some other
content, which is unknown (
unconscious
), and which requires
to be looked for. The known ideational content has only got into
its actual position owing to a false connection. We are not used to
feeling strong affects without their having any ideational content,
and therefore, if the content is missing, we seize as a substitute
upon some other content which is in some way or other suitable,
much as our police, when they cannot catch the right murderer,
arrest a wrong one instead. Moreover, this fact of there being a
false connection is the only way of accounting for the
powerlessness of logical processes to combat the tormenting
idea.’ I concluded by admitting that this new way of looking
at the matter gave immediate rise to some hard problems; for how
could he admit that his self-reproach of being a criminal towards
his father was justified, when he must know that as a matter of
fact he had never committed any crime against him?