³
As we see from this, the patient’s
tic
-like clacking and her spastic stammer were two symptoms
which went back to similar precipitating causes and had an
analogous mechanism. I have already commented on this mechanism in
a short paper on hypnotic treatment (1892-3
b
), and I shall
also return to it below.
Studies On Hysteria
56
Finding her disposed to be
communicative, I asked her what further events in her life had
frightened her so much that they had left her with plastic
memories. She replied by giving me a collection of such
experiences:- How a year after her mother’s death, she was
visiting a Frenchwoman who was a friend of hers, and had been sent
into the next room with another girl to fetch a dictionary, and had
then seen someone sit up in the bed who looked exactly like the
woman she had just left behind in the other room. She went stiff
all over and was rooted to the spot. She learnt afterwards that it
was a specially arranged dummy. I said that what she saw had been a
hallucination, and appealed to her good sense, and her face
relaxed. How she had nursed her sick brother and he had had such
fearful attacks as a result of the morphine and had terrified her
and seized hold of her. I remembered that she had already mentioned
this experience this morning, and, as an experiment, I asked her on
what other occasions this ‘seizing hold’ had happened.
To my agreeable surprise she made a long pause this time before
answering and then asked doubtfully ‘My little girl?’
She was quite unable to recall the other two occasions (see above).
My prohibition - my expunging of her memories - had therefore been
effective. - Further, how, while she was nursing her brother, her
aunt’s pale face had suddenly appeared over the top of the
screen. She had come to convert him to Catholicism.
Studies On Hysteria
57
I saw that I had come to the root
of her constant fear of surprises, and I asked for further
instances of this. She went on: How they had a friend staying at
her home who liked slipping into the room very softly so that all
of a sudden he was there; how she had been so ill after her
mother’s death and had gone to a health resort and a lunatic
had walked into her room several times at night by mistake and come
right up to her bed; and lastly, how, on the journey here from
Abbazia a strange man had four times opened the door of her
compartment suddenly and had fixed his eyes on her each time with a
stare. She was so much terrified that she sent for the
conductor.
I wiped out all these memories,
woke her up and assured her she would sleep well to-night, having
omitted to give her this suggestion in her hypnosis. The
improvement of her general condition was shown by her remark that
she had not done any reading to-day, she was living in such a happy
dream - she, who always had to be doing something because of her
inner unrest.
May 11, morning
. - To-day
she had an appointment with Dr. N., the gynaecologist, who is to
examine her elder daughter about her menstrual troubles. I found
Frau Emmy in a rather disturbed state, though this was expressed in
slighter physical signs than formerly. She called out from time to
lime: ‘I’m afraid, so afraid, I think I shall
die.’ I asked her what she was afraid of? Was it of Dr. N.?
She did not know, she said; she was just afraid. Under hypnosis,
which I induced before my colleague arrived, she declared that she
was afraid she had offended me by something she had said during the
massage yesterday which seemed to her to have been impolite. She
was frightened of anything new, too, and consequently of the new
doctor. I was able to soothe her, and though she started once or
twice in the presence of Dr. N., she behaved very well apart from
this and produced neither her clacking noises nor any inhibition of
speech. After he had gone I put her under hypnosis once more, to
remove any possible residue of the excitement caused by his visit.
She herself was very much pleased with her behaviour and put great
hopes in the treatment; and I tried to convince her from this
example that there is no need to be afraid of what is new, since it
also contains what is good.¹
¹
Didactic suggestions of this kind always
missed fire with Frau Emmy, as will be seen from what
follows.
Studies On Hysteria
58
Evening
. - She was very
lively and unburdened herself of a number of doubts and scruples
during our conversation before the hypnosis. Under hypnosis I asked
her what event in her life had produced the most lasting effect on
her and came up most often in her memory. Her husband’s
death, she said. I got her to describe this event to me in full
detail, and this she did with every sign of deepest emotion but
without any clacking or stammering: - How, she began, they had been
at a place on the Riviera of which they were both very fond, and
while they were crossing a bridge he had suddenly sunk to the
ground and lain there lifeless for a few minutes but had then got
up again and seemed quite well; how, a short time afterwards, as
she was lying in bed after her second confinement, her husband, who
had been sitting at breakfast at a small table beside her bed,
reading a newspaper, had got up all at once, looked at her so
strangely, taken a few paces forward and then fallen down dead; she
had got out of bed, and the doctors who were called in had made
efforts to revive him which she had heard from the next room; but
it had been in vain. And, she then went on to say, how the baby,
which was then a few weeks old, had been seized with a serious
illness which had lasted for six months, during which she herself
had been in bed with a high fever. - And there now followed in
chronological order her grievances against this child, which she
threw out rapidly with an angry look on her face, in the way one
would speak of someone who had become a nuisance. This child, she
said, had been very queer for a long time; it had screamed all the
time and did not sleep, and it had developed a paralysis of the
left leg which there had seemed very little hope of curing. When it
was four it had had visions; it had been late in learning to walk
and to talk, so that for a long time it had been believed to be
imbecile. According to the doctors it had had encephalitis and
inflammation of the spinal cord and she did not know what else
besides. I interrupted her here and pointed out to her that this
same child was to-day a normal girl and in the bloom of health, and
I made it impossible for her to see any of these melancholy things
again, not only by wiping out her memories of them in their
plastic
form but by removing her whole recollection of them,
as though they had never been present in her mind. I promised her
that this would lead to her being freed from the expectation of
misfortune which perpetually tormented her and from the pains all
over her body, of which she had been complaining precisely during
her narrative, after we had heard nothing of them for several
days.¹
¹
On this occasion my energy seems to have
carried me too far. When, as much as eighteen months later, I saw
Frau Emmy again in a relatively good state of health, she
complained that there were a number of most important moments in
her life of which she had only the vaguest memory. She regarded
this as evidence of a weakening of her memory, and I had to be
careful not to tell her the cause of this particular instance of
amnesia. - The overwhelming success of the treatment in this
respect was no doubt also due to the great detail in which I had
got her to repeat these memories to me (in far greater detail than
is shown in my notes), whereas with other memories I was too often
satisfied with a mere mention.
Studies On Hysteria
59
To my surprise, after this
suggestion of mine, she began without any transition speaking of
Prince L., whose escape from an asylum was being talked about a
great deal at the time. She brought out new fears about asylums -
that people in them were treated with douches of ice-cold water on
the head and put into an apparatus which turned them round and
round till they were quiet. When, three days ago, she had first
complained about her fear of asylums, I had interrupted her after
her first story, that the patients were tied on to chairs. I now
saw that I had gained nothing by this interruption and that I
cannot evade listening to her stories in every detail to the very
end. After these arrears had been made up, I took this fresh crop
of fears from her as well, I appealed to her good sense and told
her she really ought to believe me more than the silly girl from
whom she had had the gruesome stories about the way in which
asylums are run. As I noticed that she still stammered occasionally
in telling me these further things, I asked her once more what the
stammer came from. No reply. ‘Don’t you know?’
'No.’ ‘Why not?’ ‘Why not? Because I
mayn’t
!’ (She pronounced these words violently
and angrily.) This declaration seemed to me to be evidence of the
success of my suggestion, but she expressed a desire for me to wake
her up from her hypnosis, and I did so.¹
¹
It was not until the next day that I
understood this little scene. Her unruly nature, which rebelled,
both in her waking state and in artificial sleep, against any
constraint, had made her angry with me because I had assumed that
her narrative was finished and had interrupted it by my concluding
suggestion. I have come across many other proofs that she kept a
critical eye upon my work in her hypnotic consciousness. She had
probably wanted to reproach me with interrupting her story to-day
just as I had previously interrupted her accounts of the horrors in
the asylum; but she had not ventured to do so. Instead of this, she
had produced these further stories, apparently without any
transition and without revealing the connecting thoughts. My
blunder was made plain to me the next day by a depreciatory comment
on her part.
Studies On Hysteria
60
May 12
. - Contrary to my
expectation, she had slept badly and only for a short time. I found
her in a state of great anxiety, though, incidentally, without
showing her usual physical signs of it. She would not say what the
matter was, but only that she had had bad dreams and kept seeing
the same things. ‘How dreadful it would be,’ she said,
‘if they were to come to life.’ During the massage she
dealt with a few points in reply to questions. She then became
cheerful; she told me about her social life at her dower house on
the Baltic, of the important people whom she entertains from the
neighbouring town, and so on.
Hypnosis
. - She had had
some fearful dreams. The legs and arms of the chairs were all
turned into snakes; a monster with a vulture’s beak was
tearing and eating at her all over her body; other wild animals
leapt upon her, etc. She then passed on to other animal-deliria,
which, however, she qualified with the addition ‘That was
real’ (not a dream): how (on an earlier occasion) she had
been going to pick up a ball of wool, and it was a mouse and ran
away; how she had been on a walk, and a big toad suddenly jumped
out at her, and so on. I saw that my general prohibition had been
ineffective and that I should have to take her frightening
impressions away from her one by one.¹ I took an opportunity
of asking her, too, why she had gastric pains and what they came
from. (I believe that all her attacks of zoöpsia are
accompanied by gastric pains.) Her answer, which she gave rather
grudgingly, was that she did not know. I requested her to remember
by tomorrow. She then said in a definitely grumbling tone that I
was not to keep on asking her where this and that came from, but to
let her tell me what she had to say, I fell in with this, and she
went on without preface: ‘When they carried him out, I could
not believe he was dead.’ (So she was talking of her husband
again, and I saw now that the cause of her ill-humour was that she
had been suffering from the residues of this story which had been
kept back.) After this, she said, she had hated her child for three
years, because she always told herself that she might have been
able to nurse her husband back to health if she had not been in bed
on account of the child. And then after her husband’s death
there had been nothing but insults and agitations. His relatives,
who had always been against the marriage and had then been angry
because they had been so happy together, had spread a rumour that
she had poisoned him, so that she had wanted to demand an enquiry.
Her relatives had involved her in all kinds of legal proceedings
with the help of a shady journalist. The wretch had sent round
agents to stir people up against her. He got the local papers to
print libellous articles about her, and then sent her the cuttings.
This had been the origin of her unsociability and her hatred of all
strangers. After I had spoken some calming words about what she had
told me, she said she felt easier.
¹
I unfortunately failed to enquire into the
significance of Frau Emmy’s animal visions - to distinguish,
for instance, what was symbolic in her fear of animals from what
was primary horror, such as is characteristic of many neuropaths
from youth onwards.
Studies On Hysteria
61