FREUD'S CASE: RAT MAN

In the summary below, I will discuss Rat Man case, by quoting Freud directly and by summarizing and commenting what he had told. This is going to show you both the classical technique and dynamics of obsessive neurosis.  I will present you the case (Chapter titles are also taken from the case) firstly, then I will summarise Freud’s original notes and I will comment on the classical technique.

This case clearly illustrates the way Freud works with and understands the patient. It is very valuable in terms of having the originals of the session notes of Freud which were found out after his death. In the case, many concepts that emerged in later years are missing. Concepts such as defence mechanisms, self, id and superego, oedipal complex had not been clarified, but we can see that these concepts were developing. Most importantly, Freud described the dynamics of obsessive neurosis in a very clear and detailed way and observed transference.

INTRODUCTION

Freud began with emphasizing the structure of obsessive neurosis that does not allow to get into and analyse it:

“I must confess that I have not yet succeeded in completely penetrating the complicated texture of a severe case of obsessional neurosis ... What add so greatly to the difficulty of doing this are the resistances of the patients and the forms in which they are expressed.”

The strong resistances of the obsessive neurotics are typical, and the nature of the neurosis makes it impossible to get into, sometimes makes it impossible to understand. With his resistance and his desire to keep secrets and hide the content, for example, the patient does not tell the names of the people in his narrative and can make it difficult for the therapist to understand. It is also typical for the patient to tell memories selectively. In this respect, it is doubtful how well the patient complies with the rule of free association which is: "please tell me everything that is on your mind".

Freud compared his work with hysterics and obsessives frequently in the case presentation. While doing this, Freud made a contrary interpretation of the above resistance.

“The language of an obsessional neurosis -the means by which he expresses his secret thoughts- is, as it were, only a dialect of the language of hysteria … it is more nearly related to the forms of expression adopted by our conscious thought than is the language of hysteria.”

Resistance and coercion at one side, cooperation and submission at the other side go hand in hand in obsessive neurosis. Obsessive neurotics make analytical work easier because they like to be logical and thoughtful. As Freud would point out later, they use most of their libidinal investment in thought processes. But this can also turn out to be a resistance and help them to hide their unconscious, their emotions and drives. [1]

Three thing that were obvious in his analysis with Rat Man were Freud's activeness in addressing resistances, in searching the sources of obsessive thoughts or fantasies and in exploring the transference. In the first sessions Freud realized that Rat Man didn’t talk about his “lady”. In order to break this resistance Freud wanted a photo of him and her together but this made Rat Man more resistant. Today as Freud and other analysts learned much from such experiences, in classical analysis analysts never want anything from the patient and the only thing they can get from him is the fee.

EXTRACTS FROM THE CASE HISTORY

“29 years old man of university education, had suffered from obsessions ever since his childhood, but with particular intensity for the last four years. The chief features of his disorder were fears that something might happen to two people of whom he was very fond-his father and a lady whom he admired. Besides this he was aware of compulsive impulses-'-such as an impulse, for instance, to cut his throat with a razor; and further he produced prohibitions, sometimes in connection with quite unimportant things.”

At the first sentences, Freud shows the main dynamic of obsessive neurosis: the fear and wish of harming a loved object and the struggle to prevent and to protect the object.

“He had tried various treatments, but none had been of any use to him except a course of hydrotherapy at a sanatorium near --; and this, he thought, had probably only been because he had made an acquaintance there which had led to regular sexual intercourse.”

Rat Man sensed that his problem was related to sexuality and he consulted Freud. At the original session notes, Rat Man had more lively and active sexual life. The dynamics of his sexual life contains many elements about his fantasy in terms of orality, anality, trauma, intertwining of psychic representations and aggression.

(A) THE BEGINNING OF THE TREATMENT

At the beginning of the treatment Rat Man told a disappointment with an older male friend. His friend was like an older brother and he had raised Rat Man’s self-esteem so that he felt like a genius.

“This student disappointed him because he altered his behaviour and begun treating him as though he were an idiot. At length he had noticed that the student was interested in one of his sisters, and had realized that he had only taken him up in order to gain admission into the house. This had been the first great blow of his life.”

This could show Rat Man's desire for care from his father and the disappointment by his father when he showed interest in his wife. So, the Oedipal triangle which has a negative Oedipal theme came out immediately.

Also, in the transference this kind of stories show patient’s anxiety about the beginning of analysis. Freud as the older friend in the transference could disappoint Rat Man and he unconsciously told this to Freud. In the original notes the transference to Freud came out in many forms, and Freud noted them.

 (B) INFANTILE SEXUALITY

“'My sexual life began very early. I can remember a scene during my fourth or fifth year… We had a very pretty young governess called Fraulein Peter. One evening she was lying on the sofa lightly dressed, and reading. I was lying beside her, and begged her to let me creep under her skirt. She told me I might, so long as I said nothing to anyone about it. She had very little on, and I fingered her genitals and the lower part of her body, which struck me as very queer. After this I was left with a burning and tormenting curiosity to see the female body.”

While Rat Man was telling about his childhood sexuality, he told how he was abused. Because he was not prevented, he could not able to control his own impulses. The permission given by the governess must have overstimulated him and caused his neurosis to develop, made him afraid from his oedipal maternal love. On the other hand, this dynamic also casts the possibility of the problem of being too close to his mother during the process of separation. Freud didn't pay much attention to this part.

“The patient's opening words laid stress upon the influence exercised over him by men, that is to say, upon the part played in his life by homosexual object-choice; but immediately afterwards they touched upon a second motif, which was to become of great importance later on, namely, the conflict between man and woman and the opposition of their interests. Even the fact that he remembered his first pretty governess by her surname, which happened to be a man's first name, must be taken into account in this connection.”

In this footnote, Freud outlined the dynamics associated with Rat Man's neurosis again from another point of view. Firstly, his same-sex desire for an older boy —this might be called negative Oedipus later— is disappointed. After this Rat Man had associations about positive Oedipus, as having an intimacy with the opposite sex and being able to achieve it. Unfortunately, this was actually toxic and traumatic. An important detail was that the governess is referred to by the male name. So, for Rat Man, the representations of mother-father and male-female were not separated yet.

Another point is that these relations were at the level of dyadic-two person relations which are near to triadic relationship pattern. The governess did not have a rival spouse for Rat Man and the relationship with the older boy is over for Rat Man when he noticed that the student was interested in one of his sisters. So, we see an oedipal triangle in which the rival is like a shadow.

Later, Rat Man explained that another maid Lina despised him by comparing him to his sister. After this disdain, Lina explained that a maid who abused a child was imprisoned. Rat Man described how Lina made him "free" at his sexual behaviours. In fact, this "freedom" was toxic and it has destroyed Rat Man's oedipal complex, leading to his continued belief in his infantile omnipotence. Rat Man's obsessions were also "free," they harass him and cannot be inhibited.

This toxic freedom drowned him in shame. His shame about his erections when he was 6 turned into an inability to restrain himself, an obsession began as "my parents know my thoughts". This obsession seems to be a symptom of his inability at separation from his parental representations. Immediately afterward, the wish to break the boundaries became a strong desire to “see girls naked”. This desire would be punished and “he felt that if he thought about these things something bad would happen and he had to do everything to prevent them from happening”.

"If I want to see a woman naked, my father will have to die." was the form of his obsessive fear.

In these fears and obsessions, we can see Rat Man’s efforts to impose prohibitions on himself and to try to control his drives and also his efforts to separate himself from his parental representations. These efforts contain caregiver representations who did not fulfill their duty to prevent him from overwhelming drives. On the other hand, his father's harsh prohibition and punishment caused him to act harshly against himself. His father's harshness and cruelty are more visible in the original session notes.

“Such cases, unlike those of hysteria, invariably possess the characteristic of premature sexual activity. Obsessional neuroses make it much more obvious than hysterias that the factors which go to form a psychoneurosis are to be found in the patient's infantile sexual life and not in his present one. The current sexual life of an obsessional neurotic may often appear perfectly normal to a superficial observer…”

Today, we know that patients with obsessive neurosis usually have limited and isolated sexual life, and do not like to talk about their sexual life in the session. I can say that in Rat Man's sessions, the amount of sexual content is more than an ordinary obsessive neurosis patient.

 (C) THE GREAT OBSESSIVE FEAR

When Rat Man participated in military maneuvers, he lost his glasses. He telegraphed his optician to order a new one. During this break, he learned the following torture from a cruel captain and this became his great obsessive fear:

“…the criminal was tied up … a pot was turned upside down on his buttocks ... some rats were put into it ... and they...bored their way in ...’ Rat Man stopped, Freud helped him out by saying “Into his anus”

Freud entered the patient's associations like a rat, completing what he could not say. Rat Man wished to call Freud as captain, projecting his representation of cruel authority to Freud.

When Rat Man was horrified as he expressed all this, Freud continued to explore and it turned out that Rat Man had the thought that this torture should be done to the woman he admired and his dead father. The cruel captain gave the glasses that came with the post to Rat Man. Lieutenant A made the payment, and Rat Man thought that if he doesn't pay, his father and the woman would be punished. Rat Man's attempts to pay the money were complicated when the process didn't go "just the way he wanted"[2]. He couldn't keep his oath of “You should pay Lieutenant A.” because Lieutenant B made the payment. As the "pay off" job got more complicated, Rat Man referred to the help of a friend to calm down.

Freud realized that while Rat Man was describing these, he used the word "but" and gestures many times to make distortions and counter-reactions which showed that he was trying to make undoings and reaction formations. At the meantime the story was complicated and long.

“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.”

Here, Freud explains this common clinical picture again in obsessive neurosis of blocking the mind of both himself and the therapist by making the subject incomprehensible with details, undoings, reaction formations and displacements.

(D) INITIATION INTO THE NATURE OF THE TREATMENT

Rat Man described what happened at the time of his father's death, stating that it is the most important issue:

“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?'”

Freud, explained Rat Man that it was not the information that had the therapeutic effect, but the discovery of the unknown content to which the self-reproach was really attached. The repressed content was like objects found in a tomb, and their burial had been their preservation: the destruction of the material -like in Pompeii- began when it had been found and dug up. Now we know that when the unconscious material become conscious, ego has the ability to function and assimilate the unconscious material.

Rat Man also told how he could not forget his father and his deny that he had separated from him.

Rat Man's personality was divided into two as a moral self, which is conscious, and a demonic self, which is unconscious. At the end of the case Freud reformulated this.[3]

While Freud explained this disintegration, Rat Man confessed that he submitted to his demonic self as a child. At the age of 12 he fell in love with a girl, but the girl was not interested in him. Meanwhile, the thought came to his mind that if his father died, the girl might take care of him. When Freud explained that behind every fear there is a desire;

“He had at once rejected the idea with energy. And even now he could not admit the possibility that what had arisen in this way could have been a 'wish'; it had clearly been no more than a 'train of thought'.”

Freud made explanations to Rat Man[4] about the existence of his desire to get rid of his father.

Rat Man “discovered the third great characteristic of the unconscious. The source from which his hostility to his father derived its indestructibility was evidently something in the nature of sensual desires, and in that connection, he must have felt his father as in some way or other an interference.”

So, Rat Man could be under the influence of a long-repressed desire from a time before the age of 6, when he sensed his father trying to get between him and his mother/sister who he sensibly desired. Despite these explanations, Rat Man’s continuation to reject his desire to get rid of his father suggests that he is very afraid of his father. The work of analysis gave him the chance to express his thoughts and fears to Freud who was like his father in the transference. In the story he told afterwards, a woman wished her sister's death and being able to marry her husband. Freud interpreted the story that follows this rejection:

“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, … only an indirect one.”

In the footnote above we see an example of both negation and undoing. In 1925 Freud wrote a fundamental article on negation and he defined it in detail. Also negation is the core dynamic of obsessive neurosis.[5]

(E) SOME OBSESSIONAL IDEAS AND THEIR EXPLANATION

Freud explained the work of giving meaning to obsessive thoughts. While Rat Man was getting prepared for the exam, after which he could marry, his lover went to her grandmother and Rat Man was unable to work because of his longing to her. He had wanted to kill the grandmother who had in many ways "interfered" with his lover.

He gave an example of these statements regarding the patient's suicidal thoughts during this time:

“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 must go and kill the old woman.' Upon that, he had fallen to the ground, beside himself with horror.”

Freud gave another example of how his aggression was directed towards a cousin who tried to get in between him and his lover. Freud referred to Rat Man's obsessions and compulsions of protecting his lover and his undoing. He interpreted the obsession of protection as a counter-reaction to his hostile impulses. He defined these as rationalization. A conflict between love and hate continued, first one and then the other satisfied by turns. This inner conflict also continued between praying for protection and cursing.

In a daydream, this conflict had turned into a fantasy:

“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.”

In this fantasy; first he lost the woman he loves, then he revealed the evil in her husband, the woman begged to him, he showed the woman how "devoted" his love was, and retreated at the end. There was no oedipal victory or resolution of oedipal complex. In other words, women were not obtained by defeating the rival. Just like the previous examples there had been an Oedipal rivalry in which the rival was a shadow and the result was not a resolution or victory.

(F) THE PRECIPITATING CAUSE OF THE ILLNESS

At the beginning of the chapter, Freud compared hysteria with the suppression of childhood memory in obsessive neurosis.[6]

Freud described here the role of isolation in repression.[7]

Freud moved on to Rat Man's father's poor ex-girlfriend and his marriage with the daughter of a wealthy family (Rat Man's mother). Now Rat Man also had a poor lover and a wealthy family girl who was asked to marry. According to Freud, Rat Man resolved this conflict by getting ill and by not completing his education.

This pathogenic situation emerged in the transference. Rat Man met a girl on the stairs of Freud’s office, he thought this girl was Freud's daughter, and that Freud, whom he saw as a rich person, wanted to marry him to his daughter. (There are other transferential matters concerning Freud's daughter in the actual notes of the case.)[8]

(G) THE FATHER COMPLEX AND THE SOLUTION OF RAT IDEA

Freud saw a connection between Rat Man's friendly closeness with his father and his willingness to want his father's death. He examined the patient's masturbation actions in detail. He found two common features of situations in which he turned to masturbation: a prohibition and resistance to an order. This was an important memory that was experienced at the age of 3-4 and was narrated by his mother:

“he had done something naughty, for which his father had given him a beating. The little boy had flown into a terrible rage and had hurled abuse at his father even while he was under his blows. … His father, shaken by such an outburst of elemental fury, had stopped beating him, and had declared: 'The child will be either a great man or a great criminal!' … His father, he said, never beat him again; and he also attributed to this experience a part of the change which came over his own character. From that time forward he was a coward [p. 185]-out of fear of the violence of his own rage.”

While working on this memory, Rat Man was shaken when he encountered evidences of his anger towards his father. Another situation was when his father turned out to be both affectionate and friendly but also angry and overbearing.

Rat Man identified with his father as a soldier who had been in the military for a long time. During his father's military service, his father lost the money entrusted to him in gambling and became a "gambling rat" (spielratte) in German. He borrowed some money to pay to the army from his friends but couldn’t pay back. Rat Man experienced similar things during his military service. For Rat Man the subjects like who would be paid for the glasses, who was owed money, and how to reach that person could also be related to his identification with his father.

He also identified with his father regarding the choice of his spouse: would she be the poor one he loved or the rich one his father proposed.

Freud revealed a lot of meanings of rat:

• Rat punishment which he heard from the captain reminded Rat Man of the anal eroticism created by intestinal worms, which had an important place in his childhood. His unconscious had been busy about these intestinal worms. He made replacements between worm, fish and rat. In the original notes Freud found out the developments at his anal erotic drive:
  1. Intestinal worms became a source of pleasure and at the same time Rat Man gave importance to being clean.
  2. He had a phantasy of kissing the dirty legs of his love and
  3. then he became fond of his lady’s butts.
  4. He recalled that the rat punishment was for parliament members.
  5. He tried to keep his lady clean from these thoughts.
  6. His cousin told that his mother and sister are whores.
• Rat Man had interchanged the words rat (ratten) and installment (raten). When he said “So many florins, so many rats.” at the end of a session, Freud had seen the connection between money and rats.
• Rat, as the carrier of infectious diseases, and the penis, as the carrier of syphilis, were also interchanged. Freud emphasized the similarity of rats entering the anus with worms in the anus and the penis. Freud interpreted that loading the meaning of penis on Rat is linked to anal eroticism.
• He revealed similarities with some curses and the word marry (heiraten). In fairy tales, rats are substituted for children. The analogy of children to rats fits the infantile-anal birth phantasy of children being born through the anus. In this phantasy, there is no difference between parents and children because anus is not specific to a gender or generation.
• Rat Man sees himself as a rat. He was a nasty little boy like a rat and would bite people in anger.
• Rat Man had seen a rat in his father's graveyard and thought it might have eaten his father.

At the end Freud formulated the formation process of the obsession in detail.[9]

II THEORETICAL

(A) SOME GENERAL CHARACTERISTICS OF OBSESSIONAL STRUCTURES

Freud classified obsessive structures as; desires, ambitions, drives, thoughts, doubts, orders or prohibitions. These structures include contradictory situations such as desires-doubts, orders-prohibitions, drives-thoughts. This manifestaion of contrasts shows the source of ambivalence in obsessive neurosis.

Freud stated that the distorted obsessive thought can continue to exist like a dream. Freud described Rat Man's play with words and the defences he creates by making magical words. A magical word (Glejsamen) was both a powerful prayer and a substitute for sexual intercourse (Gisela-samen). Magical thinking is characteristic to obsessional neurosis.

Freud explained the emergence of omnipotence through obsessive thinking:

“If I marry the lady, some misfortune will fall my father (in the next world).' If we insert the intermediate steps, which had been skipped but were known to us from the analysis, we get the following train of thought: 'If my father was alive, he would be as furious over my desire of marrying the lady as he was in the scene in my childhood; so that I should fly into a rage with him once more and wish him every possible evil; and thanks to the omnipotence of my wishes these evils would be bound to come upon him.'”

(B) SOME PSYCHOLOGICAL PECULIARITIES OF OBSESSIONAL NEUROTICS: THEIR ATTITUDE TOWARDS REALITY, SUPERSTITION AND DEATH

The formation of some of the thoughts that came to Rat Man's mind was with; repression, forgetting, withdrawal of emotion, and disconnection. These mechanisms underline the obsessive patient's need for uncertainty and doubt, as opposed to a feeling of omnipotence. Freud stated that this is used to distract the patient from reality and to distract him from conflicting issues. Rat Man had avoided, forgot, or denied doubt-eliminating approaches. Rat Man also described the omnipotence of his love and hate at different experiences. He interpreted the death of someone he was angry with, the suicide of a woman whose love he did not respond to, as his own superstitious power.

Although Freud commented on both love and hate, the patient was describing his strong belief especially the power of his hatred, aggression, and destructiveness.

His sister died when he was 3-4 years old, which Freud thought that it was connected in his fantasies with his childish crimes at the time. His sister's death may have played an important role in Rat Man's psychopathology.

He had a memory of being beaten by his father, which affected him when his sister was sick.[10] His sister's death coincided with the anal stage and this may also have affected him. Rat Man obsessed with his sister being buried in a cemetery with rats during this period.[11]

Rat Man had been busy with his father's death since childhood, and had made an effort to cancel this fact after his father died. His superstitions mostly concerned life expectancy and the possibility of death. Rat Man has a special interest in funerals and he did not fail to attend the funerals of his acquaintances. Freud attributed the death complex of obsessive neurotics to problems in their drive life. During the development of drives, events occurred in the family and especially important events such as death can be effective in the formation of neurosis.

(C) THE INSTINCTUAL LIFE OF OBSESSIONAL NEUROTICS, AND THE ORIGINS OF COMPULSION AND DOUBT

In his twenties, Rat Man fell ill, torn between leaving the poor woman he had loved for a long time and whom his father did not want, and marrying a rich woman whom his father had proposed. His beloved “lady” sometimes made him angry with her indifference, and dissociated emotions caused obsessions and compulsions. Freud regarded the repression of Rat Man's "infantile hatred of his father brought his whole subsequent career under the dominion of the neurosis. "

Rat Man's love was opposed to his hate, and his love and hate were powerful and inseparable. This inseparability created partial paralysis and indecision in his will. Indecision and doubt caused compulsions. Freud placed displacement at a high level in the dynamic of the obsessive neurosis. Other mechanisms were reaction formation, isolation, and regression from action to thought. According to Freud, obsession is a thought that represents action in a regressive way in consciousness. This is a very interesting definition. Just as hysterical patient acts out with emotional overflow, the obsessive patient acts in thought with emotional isolation.[12]

In the last part, Freud wrote about his impression that Rat Man had dissociated into three personalities (one unconscious, two preconscious):

1. An unconscious personality in which passionate and evil impulses that were repressed at a very early age

2. a preconscious personality in which he is polite, cheerful, and understanding in his normal state —an enlightened and qualified person—

3. and a superstitious and a devout devotee.

This triad can be interpreted as follows: the unconscious (id) is very free and can think and want anything with this freedom. There is a conservative and pious piece of self that is opposed to its freedom. This “opposite and conservative” part will become the superego in the future, but in Rat Man it is still primitive and omnipotent. In between, there is an agency that strives to be harmonious, which can manifest a kind, cheerful and understanding ego. In other words, the traces of Freud's structural theory can be seen in Rat Man.

THE ORIGINAL NOTES

As I told above original session notes include more sexual and transference material. There was many information about Rat Man’s dependence to his mother but Freud didn’t comment on them in his case presentation. For example, when Freud told him the rules and frame of psychoanalysis at the first sessions Rat Man wanted to talk with his mother in order to decide.

This case is also an example of grief work of Rat Man. He had griefs of his sister and his father. His griefs were complicated with aggression, rivalry and love.

As Rat Man couldn’t get separated from his mother and father he couldn’t differentiate oral, anal and genital desires. For examole he told phantasies of oral sex, defecation into the mouth, anal production of food, dirty genitals with larvae of lice at the pubic hair and he used his faeces like penis…

Love and aggression were not differentiated, too. Death and sexuality were mixed up. Sexual relation was like making someone dirty or ill.

Freud was criticized about not being neutral. Neutrality was not so important at those days but in the original notes we can see that Freud investigated how his active attitude effect the transference:

For example Freud fed Rat Man at one of his sessions. He serviced Rat Man herring fish and pudding. Rat Man left half of the meal. He talked about how he could lose weight at the session after the meal.

After this session Freud took notes of Rat Man’s associations about this event at the other sessions.

Rat Man had a thought that Freud’s mother and wife took out the herring fish from their anus and Freud’s daughter had cut the fish. Freud linked this phantasy with his intestinal worms and Rat Man told his childhood memories in which he saw intestinal worms as fish. This phantasy shows how his oral and anal drives were not separated. Rat Man also had thoughts thad this meal had some sexual meaning:

“In this transference he thought that I made a profit out of the meal I had given him [p. 303]; for he had lost time through it and the treatment would last longer. As he handed me my fee the thought occurred to him that he ought to pay me for the meal as well, :p.amely 70 kronen. This was derived from a farce at a Budapest music hall, in which a weakly bridegroom offered a waiter 70 kronen if he would undertake the first copulation with the bride instead of him.” (p. 315)

This phantasy showed that Rat Man would give 70 kronen to Freud and Freud would copulate with his lady. Rat Man tried to free himself from the profit of Freud but at the same time he showed his need for Freud to please his lady. And also his fear of sexual relation. This dilemma is also unique to obsessive neurosis. If someone satisfies a need of obsessive neurotic, he would doubt if the other person going to gain profit. The vice versa is true, too.

CLASSICAL PSYCHOANALYSIS

This case is a very nice example of classical psychoanalysis from 1907. Freud lived 30 years more and the case didn’t get criticized too much. Through the years things have changed.

First of all, in order to be a psychoanalyst to get trough psychoanalysis became a fundamental rule. Freud didn’t get through a classic analysis so we can see that he couldn’t work much about mother-son relations in the case.

He was much more active than the analysts today. An analyst never wants photos from his patients and never give meal to them today. The relation of analyst and analysand have to be kept isolated from both environmental and real relational issues. But at the same time the real relationship of analyst with his analysand is very important. There should be no giving and getting except the fee in analysis but the warmth and trust of the real relationship is a very important aspect of therapeutic alliance.

Although Freud did different things from today he gave a very good example of the main classical analytic attitude: search for the source and search for the transference meaning of everything that happens between the analyst and analysand.

 

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[1] The unconscious of hysterical neurotics is open and uncovered, logic and thoughtfulness are infantile. In hysterical neurosis; emotionality, dissociation, and openness turn into a resistance.

[2] Obsessive neurotics want to do things “just the way the want to do”

[3] “I remarked that here he had incidentally hit upon one of the chief characteristics of the unconscious, namely, its relation to the infantile. The unconscious, I explained, was the infantile; it was that part of the self which had become separated off from it in infancy, which had not shared the later stages of its development, and which had in consequence become repressed.”

[4] According to Rat Man he was his father’s, his father was Rat Man’s best friend.

[5] Rat Man said that he wanted to kill the woman his younger brother wanted to marry because he did not see her as suitable. Then, when he told a childhood memory of attacking his "loved" brother with a toy gun. Freud stated that he may have wanted this against his father as well. Freud explained him that the impulses and desires that he condemns stem from his childhood, and that children do not have such moral responsibilities. Rat Man said that his illness got worse after his father's death.

Rat Man's attitude towards his brother is similar to his father's behaviour towards Rat Man which showed his identification. Kanzer stated that patients with obsessive neurosis lead the analysand to make explanations. Such explanations are needed sometimes in order to show the patient how the unconscious works.

[6] “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.”

[7] Freud then gave another example from an obsessive patient, who he interpreted his repression and displacement, could not bear Freud’s interpretation. With Freud's interpretation, the patient's anger emerged, but was directed towards Freud and destroyed the therapeutic alliance.

[8] There was also a dream that proved Rat Man’s belief in Freud's wealth:

“He dreamt that he saw my daughter in front of him; she had two patches of dung instead of eyes. No one who understands the language of dreams will find much difficulty in translating this one: it declared that he was marrying my daughter not for her 'beaux yeux' hutfor her money.”

[9] “When, at the afternoon halt (during which he had lost his pince-nez, his eye glasses), the captain had told him about Rat punishment, the patient had only been struck at first by the combined cruelty and lasciviousness of the situation depicted. But immediately afterwards a connection had been set up with the scene from his childhood in which he himself had bitten someone. The captain-a man who could defend such punishments-had become a substitute for his father, and had thus drawn down upon himself a part of the reviving animosity which had burst out, on the original occasion, against his cruel father. … when the captain had handed him the packet upon which the charges were due and had requested him to pay back the 3.80 kronen to Lieutenant A. [p. 168], he had already been aware that his 'cruel superior' captain was making a mistake, and that the only person he owed anything to was the young lady at the post office. It might easily, therefore, have occurred to him to think of some derisive reply, such as, 'Will I, though?' or 'Pay your grandmother!' or 'Yes! You bet I'll pay him back the money!'

But instead, out of his memory of the scene from his childhood, there formed an obsession: 'Yes! I'll pay back the money to A. when my father and the lady have children!' This thought had been considered a crime like action and should be punished with a rat. Guilt turned into an oath and obedience.

[10] He had a sick girlfriend like his sister and married this woman who had her ovaries removed and got back to pre-puberty.

[11] Maybe he believed in his omnipotent fantasies that he could kill his father when he entered the oedipal phase because of the death of his sister, whom he was jealous of.

[12] Freud linked compulsion with autoerotic action. The “sexual instinct of looking and knowing [the scopophilic and epistemophilic instinct] developed early and repressed prematurely. The power of the epistemophilic instinct had sexualized the thought process.” Obsessive thinking was protected by the distortions, delays and generalizations it undergoes before it became conscious.