Freud - Complete Works (369 page)

  
¹
It is never the aim of discussions like
this to create conviction. They are only intended to bring the
repressed complexes into consciousness, to set the conflict going
in the field of conscious mental activity, and to facilitate the
emergence of fresh material from the unconscious. A sense of
conviction is only attained after the patient has himself worked
over the reclaimed material, and so long as he is not fully
convinced the material must be considered as
unexhausted.

Notes Upon A Case Of Obsessional Neurosis

2146

   At the next session, which was
the seventh, he took up the same subject once more. He could not
believe, he said, that he had ever entertained such a wish against
his father. He remembered a story of Sudermann’s, he went on,
that had made a deep impression upon him. In this story there was a
woman who, as she sat by her sister’s sick-bed, felt a wish
that her sister should die so that she herself might marry her
husband. The woman thereupon committed suicide, thinking she was
not fit to live after being guilty of such baseness. He could
understand this, he said, and it would be only right if his
thoughts were the death of him, for he deserved nothing less.¹
- I remarked that it was well known to us that patients derived a
certain satisfaction from their sufferings, so that in reality they
all resisted their own recovery to some extent. He must never lose
sight of the fact that a treatment like ours proceeded to the
accompaniment of a
constant resistance
; I should be
repeatedly reminding him of this fact.

   He then went on to say that he
would like to speak of a criminal act, whose author he did not
recognize as himself, though he quite clearly recollected
committing it. He quoted a saying of Nietzsche’s:²
‘"I did this," says my Memory. "I cannot have
done this," says my Pride and remains inexorable. In the end -
Memory yields.’ ‘Well,’ he continued, ‘my
memory has
not
yielded on this point.’ - ‘That
is because you derive pleasure from your self-reproaches as a means
of self-punishment.’ - ‘My younger brother - I am
really very fond of him now, and he is causing me a great deal of
worry just at present, for he wants to make what I consider a
preposterous match; I have thought before now of going and killing
the person concerned so as to prevent his marrying her -well, my
younger brother and I used to fight a lot when we were children. We
were very fond of each other at the same time, and were
inseparable; but I was plainly filled with jealousy, as he was the
stronger and better-looking of the two and consequently the
favourite.’ - ‘Yes. You have already given me a
description of a scene of jealousy in connection with Fräulein
Lina.’ - ‘Very well then, on some such occasion (it was
certainly before I was eight years old, for I was not going to
school yet, which I began to do when I was eight) - on some such
occasion, this is what I did. We both had toy guns of the usual
make. I loaded mine with the ram rod and told him that if he looked
up the barrel he would see something. Then, while he was looking
in, I pulled the trigger. He was hit on the forehead and not hurt;
but I had meant to hurt him very much indeed. Afterwards I was
quite beside myself, and threw myself on the ground and asked
myself however I could have done such a thing. But I
did
do
it.’ - I took the opportunity of urging my case. If he had
preserved the recollection of an action so foreign to him as this,
he could not, I maintained, deny the possibility of something
similar, which he had now forgotten entirely, having happened at a
still earlier age in relation to his father. - He then told me he
was aware of having felt other vindictive impulses, this time
towards the lady he admired so much, of whose character he painted
a glowing picture. It might be true, he said, that she could not
love easily; but she was reserving her whole self for the one man
to whom she would some day belong. She did not love him. When he
had become certain of that, a conscious phantasy had taken shape in
his mind of how he should grow very rich and marry some one else,
and should then take her to call on the lady in order to hurt her
feelings. But at that point the phantasy had broken down, for he
had been obliged to own to himself that the other woman, his wife,
was completely indifferent to him; then his thoughts had become
confused, till finally it had been clearly borne in upon him that
this other woman would have to die. In this phantasy, just as in
his attempt upon his brother, he recognized the quality of
cowardice
which was so particularly horrible to him.³ -
In the further course of our conversation I pointed out to him that
he ought logically to consider himself as in no way responsible for
any of these traits in his character; for all of these
reprehensible impulses originated from his infancy, and were only
derivatives of his infantile character surviving in his
unconscious; and he must know that moral responsibility could not
be applied to children. It was only by a process of development, I
added, that a man, with his moral responsibility, grew up out of
the sum of his infantile predispositions.
⁴
He expressed a doubt, however,
whether all his evil impulses had originated from that source. But
I promised to prove it to him in the course of the treatment.

   He went on to adduce the fact of
his illness having become so enormously intensified since his
father’s death; and I said I agreed with him in so far as I
regarded his sorrow at his father’s death as the chief source
of the
intensity
of his illness. His sorrow had found, as it
were, a pathological expression in his illness. Whereas, I told
him, a normal period of mourning would last from one to two years,
a pathological one like this would last indefinitely.

   This is as much of the present
case history as I am able to report in a detailed and consecutive
manner. It coincides roughly with the expository portion of the
treatment; this lasted in all for more than eleven months.

  
¹
This sense of guilt involves the most
glaring contradiction of his opening denial that he had ever
entertained such an evil wish against his father. This is a common
type of reaction to repressed material which has become conscious:
the ‘No’ with which the fact is first denied is
immediately followed by a confirmation of it, though, to begin
with, only an indirect one.

  
²
Jenseits von Gut und Böse
, iv.
68.

  
³
This quality of his will find an
explanation later on.

  
⁴
I
only produced these arguments so as once more to demonstrate to
myself their inefficacy. I cannot understand how other
psychotherapists can assert that they successfully combat neuroses
with such weapons as these.

Notes Upon A Case Of Obsessional Neurosis

2147

(E)  SOME OBSESSIONAL IDEAS AND THEIR
EXPLANATION

   Obsessional ideas, as is well
known, have an appearance of being either without motive or without
meaning, just a dreams have. The first problem is how to give them
a sense and a status in the subject’s mental life, so as to
make them comprehensible and even obvious. The problem of
translating them may seem insoluble; but we must never let
ourselves be misled by that illusion. The wildest and most
eccentric obsessional ideas can be cleared up if they are
investigated deeply enough. The solution is effected by bringing
the obsessional ideas into temporal relationship with the
patient’s experiences, that is to say, by enquiring when a
particular obsessional idea made its first appearance and in what
external circumstances it is apt to recur. When, as so often
happens, an obsessional idea has not succeeded in establishing
itself permanently, the task of clearing it up is correspondingly
simplified. We can easily convince ourselves that, when once the
interconnections between an obsessional idea and the
patient’s experiences have been discovered, there will be no
difficulty in obtaining access to whatever else may be puzzling or
worth knowing in the pathological structure we are dealing with -
its meaning, the mechanism of its origin, and its derivation from
the preponderant motive forces of the patient’s mind.

   As a particularly clear example I
will begin with one of the
suicidal impulses
which appeared
so frequently in our patient. This instance almost analysed itself
in the telling. He had once, he told me, lost some weeks of study
owing to his lady’s absence: she had gone away to nurse her
grandmother, who was seriously ill. Just as he was in the middle of
a very hard piece of work the idea had occurred to him: ‘If
you received a command to take your examination this term at the
first possible opportunity, you might manage to obey it. But if you
were commanded to cut your throat with a razor, what then?’
He had at once become aware that this command had already been
given, and was hurrying to the cupboard to fetch his razor when he
thought: ‘No, it’s not so simple as that. You
must¹ go and kill the old woman.’ Upon that, he had
fallen to the ground, beside himself with horror.

   In this instance the connection
between the compulsive idea and the patient’s life is
contained in the opening words of his story. His lady was absent,
while he was working very hard for an examination so as to bring
the possibility of an alliance with her nearer. While he was
working he was overcome by a longing for his absent lady, and he
thought of the cause of her absence. And now there came over him
something which, if he had been a normal man, would probably have
been some kind of feeling of annoyance with her grandmother:
‘Why must the old woman get ill just at the very moment when
I’m longing for
her
so frightfully?’ We must
suppose that something similar but far more intense passed through
our patient’s mind - an unconscious fit of rage which could
combine with his longing and find expression in the exclamation:
‘Oh, I should like to go and kill that old woman for robbing
me of my love!’ Thereupon followed the command: ‘Kill
yourself, as a punishment for these savage and murderous
passions!’ The whole process then passed into the obsessional
patient’s consciousness accompanied by the most violent
affect and
in a reverse order
- the punitive command coming
first, and the mention of the guilty outburst afterwards. I cannot
think that this attempt at an explanation will seem forced or that
it involves many hypothetical elements.

  
¹
The sense requires that the word
‘first’ should be interpolated here.

Notes Upon A Case Of Obsessional Neurosis

2148

   Another impulse, which might be
described as
indirectly
suicidal and which was of longer
duration, was not so easily explicable. For its relation to the
patient’s experiences succeeded in concealing itself behind
one of those purely external associations which are so obnoxious to
our consciousness. One day while he was away on his summer holidays
the idea suddenly occurred to him that he was too fat [German
‘
dick
’] and that he must
make himself
slimmer
. So he began getting up from table before the pudding
came round and tearing along the road without a hat in the blazing
heat of an August sun. Then he would dash up a mountain at the
double, till, dripping with perspiration, he was forced to come to
a stop. On one occasion his suicidal intentions actually emerged
without any disguise from behind this mania for slimming: as he was
standing on the edge of a steep precipice he suddenly received a
command to jump over, which would have been certain death. Our
patient could think of no explanation of this senseless obsessional
behaviour until it suddenly occurred to him that at that time his
lady had also been stopping at the same resort; but she had been in
the company of an English cousin, who was very attentive to her and
of whom the patient had been very jealous. This cousin’s name
was Richard, and, according to the usual practice in England, he
was known as
Dick
. Our patient, then, had wanted to kill
this Dick; he had been far more jealous of him and enraged with him
than he could admit to himself, and that was why he had imposed on
himself this course of slimming by way of a punishment. This
obsessional impulse may seem very different from the directly
suicidal command which was discussed above, but they have
nevertheless one important feature in common. For they both arose
as reactions to a tremendous feeling of rage, which was
inaccessible to the patient’s consciousness and was directed
against some one who had cropped up as an interference with the
course of his love.¹

  
¹
Names and words are not nearly so
frequently or so recklessly employed in obsessional neuroses as in
hysteria for the purpose of establishing a connection between
unconscious thoughts (whether they are impulses or phantasies) and
symptoms. I happen, however, to recollect another instance in which
the very same name, Richard, was similarly used by a patient whom I
analysed a long time since. After a quarrel with his brother he
began brooding over the best means of getting rid of his fortune,
and declaring that he did not want to have anything more to do with
money, and so on. His brother was called Richard, and
‘
richard
’ is the French for ‘a rich
man’.