Freud saw the Ratman for about a year, and considered the treatment a success. The patient was presented with obsessional thoughts and with behaviors which he felt compelled to carry out. Freud theorized that this and similar thoughts were produced by conflicts consisting of the combination of loving and aggressive impulses relating to these people. The Ratman also often defended himself against his own thoughts. He would have a secret thought that he wished his father would die so he could inherit all of his money, and then he would shame himself by fantasizing that his father would die and leave him nothing.
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All Rights Reserved. These are my personal opinions and interests in psychology. I am not a psychologist so my conclusions should not replace specific professional help. These reviews are only meant to spark discussion and motivate people to read books that are not typically in a school curriculum.
His patient complained about long standing compulsive ideas that were getting worse. This was what later analysts had to avoid in order to update psychoanalysis to their fresh clinical observations.
Patrick was able to compare the original process notes with the published case, make improved translations, and correct some of the chronology. Psychoanalysis is a long process, and Freud was unfortunately not able to produce published case studies that were long enough to affect a full cure, despite his claims of achieving cures.
Some of the misgivings that Freud had were not entirely out of modesty. His oral report to the Congress was a success, but much was removed in print.
The more unconscious intentions are made conscious to the patient, the more understanding there is, and the more the patient understands how counter-productive their thinking patterns are, the more they are motivated to cease them. For example, the inhibitions due to superstitious beliefs and omnipotent rituals to control reality, that this patient believed in, were draining his energy and misdirecting it away from his needed work.
A true cure would be to get any patient to think more scientifically and act more assertively about their projects. Since this applies to everyone, a more comprehensive cure would have to also analyze how bias and prejudice from the analyst would interfere with a deeper cure.
Seeing how defenses can transfer from past targets onto new targets is a transference insight that can help patients see their neurosis in action, but Freud was only beginning to see how his own transference was limiting his case studies. He readily admitted to preferring to develop theories rather than actively treating patients. Since he had not been analyzed himself, he tended to commit two kinds of errors.
First, he had practiced suggestion too long not to have been materially affected by it. When he was persuaded of the truth of something, he had considerable difficulty in waiting until this verity became clear to his patient.
Freud wanted to convince him immediately. Because of that, he talked too much. Second, one rapidly sensed what special theoretical question preoccupied him, for often during the analytic hour he developed at length new points of view he was clarifying in his own mind. The associations that the patient makes gives clues to the sore spot in the mind hiding in the unconscious.
This is a universal aspect to anyone sensitive enough to feel bad about themselves. Gradually as the sore-spot is exposed, many associations are revealed. They include inhibitions, envy, desire and useless rituals that drain energy. One of the big ones is a lack of understanding of the opposite sex. Like a male patient going to a female psychologist without the proper experience, or in the case of Freud, his lack of understanding of female psychology, limited his ability to discover insights based on female influences on his patients.
The problem of a positive transference is that there will be too much regard which can prevent increasing depth in the case study. Gisela being from a family that his mother did not approve of, and would eventually become infertile, created a lot of ambivalence in his choice. When I ask what causes him to put particular emphasis on information about his sexual life he replies that that is what he knows about my theories.
He has no such opportunities here and has intercourse rarely and at irregular intervals. Prostitutes are repugnant to him. His sex life has been altogether wretched, and masturbation has played only a minor role, when he was 16 or His potency is normal, he claims; he first had intercourse at the age of I remember a scene that took place when I was 3 or 4 years old, which came into my mind quite clearly years later.
One evening she was lying on the sofa reading, quite scantily dressed; I was lying next to her and asked for permission to crawl under her petticoats.
She said I could, provided that I did not tell anyone. She was not wearing much, and I touched her genitals and her belly, which I found rather odd. Since then I have felt a burning, tormenting curiosity to see the female body. I can still remember with what feeling of suspense I waited at the Baths, where I was still allowed to go with my sisters and governess, for our governess to take off her clothes and enter the water.
From the age of 5 I can remember more. We had another governess then, also young and pretty, who had abscesses on her bottom which she used to squeeze every evening. I would wait furtively for that moment to ease my curiosity. We were all sitting together one evening, the governess, the cook, another girl, my brother who was 18 months younger, and myself. Paula comforted me and told me that a girl who had done something similar with a little lad in her care had been locked up for several months.
I do not think she got up to any mischief with me, but I was allowed to take all sorts of liberties with her. When I came into her bedroom I would pull the covers off her and touch her and she would never try to stop me. She was not very intelligent and obviously very needy sexually. This student later became his private tutor and changed his attitude towards him quite suddenly, treating him like the worst kind of fool.
I remember too that I had to overcome certain scruples in order to do so, for I already sensed that there was some connection with my fantasies and my curiosity and for some time back then harboured a morbid notion that my parents knew what I was thinking, which I explained to myself by saying that I had articulated my thoughts without hearing them myself.
I see this as the beginning of my illness. To Freud it was like he had an unconscious perception of what was repressed but it could not become clear, other than it vaguely involved his father. When doing military exercises, which helped him to calm compulsive ideas, he wanted to prove his worth to career officers in his outfit. In a halt during a march he lost his pince-nez glasses, and carried on without them. I felt a certain fear of this man, for he obviously took pleasure in cruelty.
Into the anus, I added, helping him out. The idea represents a wish and a fear. The Father being the earlier idea than the lady, Freud guesses that the father is included in this torture.
Now he is forced to admit that at the same time there surfaced another idea, that the punishment should also be applied to his father. These impulses are generally subdued in her presence and come to the fore only in her absence. The demand from the torture loving captain triggered his wish to pay the money back and to not pay the money back.
He filled up the intervening time with efforts to pay back the small sum of money to Lieutenant A. It caused him some consternation to realize that he could not keep his vow because it was based on a false premiss and he dreamed up the most bizarre solutions to his problem: he would go to the post office with both A.
It was the post-office woman herself. She met with an officer and asked about Lanzer. She told him that she would pay for the charges herself so he could get his glasses sooner. When the sadistic captain gave him the wrong instructions, Lanzer knew they were wrong, but his compulsions sowed doubt and he followed his pathological vows anyways.
When obsessive rituals take hold they are emotionally invested and must be carried out to gain relief. Ambivalence is increased when opposite choices are available and worries of punishment lie on both sides. If Lanzer pays the money he worries that rat torture will happen to Gisela and his Father.
Ernst identified with his father and associated repayment with being better than his father was. All these worries clouded the simple answer of just going to the post office lady and paying her directly. One has to imagine vividly so that the emotions well up partially inside oneself to feel the bind an obsessive person is in.
Their emotions override facts and carry them away. Intrusive thoughts. Those figures influenced him emotionally and he communicated with them. It means with distorted logic, or displacement, distorted emotions follow. We are not used to sensing strong emotions in ourselves without idea-content, and so in the absence of a content we take a different one, which seems more or less to fit, as a surrogate, much as our police, if they cannot catch the real murderer, will arrest the wrong person in his place.
The fact that inaccurate links are made also accounts in itself for the impotence of logic in combating the tormenting idea. Freud goes onto use an archaeological metaphor of Pompeii for unearthing what is unconscious.
The moral person was the conscious part, the wicked one the unconscious part. The unconscious mind can roil in short-term destructive goals that scare the conscious mind which represses it. When people see frustrated goals, the lack of skill in dealing with problems shows itself in vengeful thoughts and actions that hurt oneself and society. One can see this acted out in soap operas and pulpy dramas. Impulses without the accompanying skill lead to these kind of dramas in the mind.
Lanzer recounted a childhood story that had that unskilled reaction when he was slighted by a girl who was not as affectionate towards him as he wanted her to be. The desire to want to change people is a form of self-created stress.
He had a similar thought towards the Gisela. He must not lose sight of the fact that a treatment of the kind we were undertaking would inevitably be accompanied by constant resistance; I should be reminding him of this fact over and over again. For a lot of people in analysis, it can be a recording of a list of grudges and desires for revenge against those who interfered with their pleasure.
His lady was absent while he was studying strenuously for an examination that would make union with her a more realistic possibility. While studying he was overtaken by longing for his absent love and the thought of the reason for her absence. This obsession was like that of a stalker that must always know the whereabouts of the target and everything the target says is interpreted with this lens of control and suspicion.
In the summer they found the opportunity to bring the matter out into the open and the lady was able to prove to him that her words, which he had taken the wrong way, had in fact been intended to protect him from ridicule of others. Now he was again very happy. It is of course misunderstood in the conscious thought processes of the patient and given a secondary motivation — i.
Its true meaning lies in its depiction of the conflict between two more or less equally strong opposing impulses, opposites which, in my experience to date, are always those of love and hate. He also displayed these ambivalent behaviours with his other intimate relationships.
Rat Man: A Case of 'Obsessional Neurosis'
All Rights Reserved. These are my personal opinions and interests in psychology. I am not a psychologist so my conclusions should not replace specific professional help. These reviews are only meant to spark discussion and motivate people to read books that are not typically in a school curriculum. His patient complained about long standing compulsive ideas that were getting worse.
Case Studies: The ‘Ratman’ – Sigmund Freud
He was diagnosed as a case of obsessive-compulsive disorder by Sigmund Freud known as obsessional neurosis that time. The patient presented to Freud with number of distressing obsessions of which the main one was fear of a corporal punishment to his loved ones using rats. The patient underwent psychoanalytic treatment for his symptoms for 6 months following which he was declared cured. Freud has discussed the case in a published case note. Over the subsequent years, the case received wider attention from the psychoanalytic community and continues to be interpreted and discussed from different perspectives after nearly one century of his clinical interaction with Freud.
Freud treated his patient for a little over three months on a regular daily basis. The treatment was irregular for the next three months and sporadic, at best, after that. Lanzer claimed that he fantasized about murder and suicide, and developed a number of compulsive irrational behavior patterns. For example, he mentioned his habit of opening the door to his flat between 12 midnight and A. Lanzer would then stare at his penis, sometimes using a mirror. In the end — Memory yields". Just after Freud had completed the written version of the case history in October , he confessed to Jung that his patient was still having ongoing problems.