Freud - Complete Works (370 page)

Notes Upon A Case Of Obsessional Neurosis

2149

   Some other of the patient’s
obsessions, however, though they too were centred upon his lady,
exhibited a different mechanism and owed their origin to a
different instinct. Besides his slimming mania he produced a whole
series of other obsessional activities at the period during which
the lady was stopping at his summer resort; and, in part at least,
these directly related to her. One day, when he was out with her in
a boat and there was a stiff breeze blowing, he was obliged to make
her put on his cap, because a command had been formulated in his
mind that
nothing must happen to her
.¹ This was a kind
of
obsession for protecting
, and it bore other fruit besides
this. Another time, as they were sitting together during a
thunderstorm, he was obsessed, he could not tell why, with the
necessity for counting
up to forty or fifty between each
flash of lightning and its accompanying thunder-clap. On the day of
her departure he knocked his foot against a stone lying in the
road, and was
obliged
to put it out of the way by the side
of the road, because the idea struck him that her carriage would be
driving along the same road in a few hours’ time and might
come to grief against this stone. But a few minutes later it
occurred to him that this was absurd, and he was
obliged
to
go back and replace the stone in its original position in the
middle of the road. After her departure he became a prey to an
obsession for understanding
, which made him a curse to all
his companions. He forced himself to understand the precise meaning
of every syllable that was addressed to him, as though he might
otherwise be missing some priceless treasure. Accordingly he kept
asking: ‘What was it you said just then?‘ And after it
had been repeated to him he could not help thinking it had sounded
different the first time, so he remained dissatisfied.

  
¹
The words ‘for which he might be to
blame’ must be added to complete the sense.

Notes Upon A Case Of Obsessional Neurosis

2150

   All of these products of his
illness depended upon a certain circumstance which at that time
dominated his relations to his lady. When he had been taking leave
of her in Vienna before the summer holidays, she had said something
which he had construed into a desire on her part to disown him
before the rest of the company; and this had made him very unhappy.
During her stay at the holiday resort there had been an opportunity
for discussing the question, and the lady had been able to prove to
him that these words of hers which he had misunderstood had on the
contrary been intended to save him from looking ridiculous. This
made him very happy again. The clearest allusion to this incident
was contained in the obsession for understanding. It was
constructed as though he were saying to himself: ‘After such
an experience you must never misunderstand any one again, if you
want to spare yourself unnecessary distress.’ This resolution
was not merely a generalization from a single occasion, but it was
also displaced - perhaps on account of the lady’s absence -
from a single highly valued individual on to all the remaining
inferior ones. And the obsession cannot have arisen solely from his
satisfaction at the explanation she had given him; it must have
expressed something else besides, for it ended in an unsatisfying
doubt as to whether what he had heard had been correctly
repeated.

   The other compulsive commands
that have been mentioned put us upon the track of this other
element. His obsession for protecting can only have been a reaction
- as an expression of remorse and penitence - to a contrary, that
is a hostile, impulse which he must have felt towards his lady
before they had their
éclaircissement
. His obsession
for counting during the thunderstorm can be interpreted, with the
help of some material which he produced, as having been a defensive
measure against fears that some one was in danger of death. The
analysis of the obsessions which we first considered has already
warned us to regard our patient’s hostile impulses as
particularly violent and as being in the nature of senseless rage;
and now we find that even after their reconciliation his rage
against the lady continued to play a part in the formation of his
obsessions. His doubting mania as to whether he had heard correctly
was an expression of the doubt still lurking in his mind, whether
he had really understood his lady correctly this time and whether
he had been justified in taking her words as a proof of her
affection for him. The doubt implied in his obsession for
understanding was a doubt of her love. A battle between love and
hate was raging in the lover’s breast, and the object of both
these feelings was one and the same person. The battle was
represented in a plastic form by his compulsive and symbolic act of
removing the stone from the road along which she was to drive, and
then of undoing this deed of love by replacing the stone where it
had lain, so that her carriage might come to grief against it and
she herself be hurt. We shall not be forming a correct judgement of
this second part of the compulsive act if we take it at its face
value as having merely been a critical repudiation of a
pathological action. The fact that it was accompanied by a sense of
compulsion betrays it as having itself been a part of the
pathological action, though a part which was determined by a motive
contrary to that which produced the first part.

Notes Upon A Case Of Obsessional Neurosis

2151

   Compulsive acts like this, in two
successive stages, of which the second neutralizes the first, are a
typical occurrence in obsessional neuroses. The patient’s
consciousness naturally misunderstands them and puts forward a set
of secondary motives to account for them -
rationalizes
them, in short. (Cf. Jones, 1908.) But their true significance lies
in their being a representation of a conflict between two opposing
impulses of approximately equal strength: and hitherto I have
invariably found that this opposition has been one between love and
hate. Compulsive acts of this sort are theoretically of special
interest, for they show us a new type of method of constructing
symptoms. What regularly occurs in hysteria is that a compromise is
arrived at which enables both the opposing tendencies to find
expression simultaneously - which kills two birds with one
stone;¹ whereas here each of the two opposing tendencies finds
satisfaction singly, first one and then the other, though naturally
an attempt is made to establish some sort of logical connection
(often in defiance of all logic) between the antagonists.²

  
¹
Cf. ‘Hysterical Phantasies and their
Relation to Bisexuality’ (Freud, 1908
a
).

  
²
Another obsessional patient once told me
the following story. He was walking one day in the park at
Schönbrunn when he kicked his foot against a branch that was
lying on the ground. He picked it up and flung it into the hedge
that bordered the path. On his way home he was suddenly seized with
uneasiness that the branch in its new position might perhaps be
projecting a little from the hedge and might cause an injury to
some one passing by the same place after him. He was obliged to
jump off his tram, hurry back to the park, find the place again,
and put the branch back in its former position - although any one
else but the patient would have seen that, on the contrary, it was
bound to be more dangerous to passers-by in its original position
than where he had put it in the hedge. The second and hostile act,
which he carried out under compulsion, had clothed itself to his
conscious view with the motives that really belonged to the first
and philanthropic one.

Notes Upon A Case Of Obsessional Neurosis

2152

   The conflict between love and
hatred showed itself in our patient by other signs as well. At the
time of the revival of his piety he made up prayers for himself,
which took up more and more time and eventually lasted for an hour
and a half. The reason for this was that he found, like an inverted
Balaam, that something always inserted itself into his pious
phrases and turned them into their opposite. E.g., if he said,
‘May God protect him’, an evil spirit would hurriedly
insinuate a ‘not’.¹ On one such occasion the idea
occurred to him of cursing instead, for in that case, he thought,
the contrary words would be sure to creep in. His original
intention, which had been repressed by his praying, was forcing its
way through in this last idea of his. In the end he found his way
out of his embarrassment by giving up the prayers and replacing
them by a short formula concocted out of the initial letters or
syllables of various prayers. He then recited this formula so
quickly that nothing could slip into it.

   He once brought me a dream which
represented the same conflict in relation to his transference on to
the physician. He dreamt that my mother was dead; he was anxious to
offer me his condolences, but was afraid that in doing so he might
break into
an impertinent laugh
, as he had repeatedly done
on similar occasions in the past. He preferred, therefore, to leave
a card on me with ‘p. c.’ written on it; but as he was
writing them the letters turned into ‘p. f.’²

  
¹
Compare the similar mechanism in the
familiar case of sacrilegious thoughts entering the minds of devout
persons.

  
²
[The customary abbreviations for
‘
pour condoler
’ and ‘
pour
féliciter
’ respectively.] This dream provides the
explanation of the compulsive laughter which so often occurs on
mournful occasions and which is regarded as such an unaccountable
phenomenon.

Notes Upon A Case Of Obsessional Neurosis

2153

   The mutual antagonism between his
feelings for his lady was too marked to have escaped his conscious
perception entirely, although we may conclude from the obsessions
in which it was manifested that he did not rightly appreciate the
depth of his negative impulses. The lady had refused his first
proposal, ten years earlier. Since then he had to his own knowledge
passed through alternating periods, in which he either believed
that he loved her intensely, or felt indifferent to her. Whenever
in the course of the treatment he was faced by the necessity of
taking some step which would bring him nearer the successful end of
his courtship, his resistance usually began by taking the form of a
conviction that after all he did not very much care for her -
though this resistance, it is true, used soon to break down. Once
when she was lying seriously ill in bed and he was most deeply
concerned about her, there crossed his mind as he looked at her a
wish that she might lie like that for ever. He explained this idea
by an ingenious piece of sophistry: maintaining that he had only
wished her to be permanently ill so that he might be relieved of
his intolerable fear that she would have a repeated succession of
attacks!¹ Now and then he used to occupy his imagination with
day-dreams, which he himself recognized as ‘phantasies of
revenge’ and felt ashamed of. Believing, for instance, that
the lady set great store by the social standing of a suitor, he
made up a phantasy in which she was married to a man of that kind,
who was in some government office. He himself then entered the same
department, and rose much more rapidly than her husband, who
eventually became his subordinate. One day, his phantasy proceeded,
this man committed some act of dishonesty. The lady threw herself
at his feet and implored him to save her husband. He promised to do
so, and informed her that it had only been for love of her that he
had entered the service, because he had foreseen that such a moment
would occur; and now that her husband was saved, his own mission
was fulfilled and he would resign his post.

   He produced other phantasies in
which he did the lady some great service without her knowing that
it was he who was doing it. In these he only recognized his
affection, without sufficiently appreciating the origin and aim of
his magnanimity, which was designed to repress his thirst for
revenge, after the manner of Dumas’ Count of Monte-Cristo.
Moreover he admitted that occasionally he was overcome by quite
distinct impulses to do some mischief to the lady he admired. These
impulses were mostly in abeyance when she was there, and only
appeared in her absence.

  
¹
It cannot be doubted that another
contributory motive to this compulsive idea was a wish to know that
she was powerless against his designs.

Notes Upon A Case Of Obsessional Neurosis

2154

(F)  THE PRECIPITATING CAUSE OF THE
ILLNESS

   One day the patient mentioned
quite casually an event which I could not fail to recognize as the
precipitating cause of his illness, or at least as the immediate
occasion of the attack which had begun some six years previously
and had persisted to that day. He himself had no notion that he had
brought forward anything of importance; he could not remember that
he had ever attached any importance to the event; and moreover he
had never forgotten it. Such an attitude on his part calls for some
theoretical consideration.

   In hysteria it is the rule that
the precipitating causes of the illness are overtaken by amnesia no
less than the infantile experiences by whose help the precipitating
causes are able to transform their affective energy into symptoms.
And where the amnesia cannot be complete, it nevertheless subjects
the recent traumatic precipitating cause to a process of erosion
and robs it at least of its most important components. In this
amnesia we see the evidence of the repression which has taken
place. The case is different in obsessional neuroses. The infantile
preconditions of the neurosis may be overtaken by amnesia, though
this is often an incomplete one; but the immediate occasions of the
illness are, on the contrary, retained in the memory. Repression
makes use of another, and in reality a simpler, mechanism. The
trauma, instead of being forgotten, is deprived of its affective
cathexis; so that what remains in consciousness is nothing but its
ideational content, which is perfectly colourless and is judged to
be unimportant. The distinction between what occurs in hysteria and
in an obsessional neurosis lies in the psychological processes
which we can reconstruct behind the phenomena; the
result
is
almost always the same, for the colourless mnemic content is rarely
reproduced and plays no part in the patient’s mental
activity. In order to differentiate between the two kinds of
repression we have on the surface nothing to rely upon but the
patient’s assurance that he has a feeling in the one case of
having always known the thing and in the other of having long ago
forgotten it.¹