2383
TWO INSTANCES OF PATHOGENIC PHANTASIES
REVEALED BY THE PATIENTS THEMSELVES
A
A short while ago I saw a patient, about twenty years of age, who gave an unmistakable picture (confirmed by other opinions) of a dementia praecox (hebephrenia). During the initial stages of his illness he had exhibited periodic changes of mood and had made a considerable improvement. While he was in this favourable condition he was removed from the institution by his parents and for about a week he was regaled with entertainments of every kind to celebrate his supposed recovery. His relapse followed immediately upon this week of festivities. When he was brought back to the institution, he said that the consulting physician had advised him ‘to flirt with his mother a little’. There can be no doubt that in this delusory paramnesia he was giving expression to the excitement which had been provoked in him by being in his mother’s company and which had been the immediate provocation of his relapse.
B
More than ten years ago, at a time when the findings and hypotheses of psycho-analysis were known to only a few people, the following events were reported to me from a trustworthy source. A girl, who was the daughter of a medical man, fell ill of hysteria with local symptoms. Her father denied that it was hysteria and arranged for various somatic treatments to be initiated, which brought little improvement. One day a woman friend of the patient’s said to her: ‘Have you never thought of consulting Dr. F.?’ To which the patient replied: ‘What good would that be? I know he’d say to me: "Have you ever had the idea of having sexual intercourse with your father?"' - It seems unnecessary for me to say explicitly that it has never been my practice and is not my practice to-day to ask such questions. But it is worth remarking that much of what patients report of the words and actions of their physicians may be understood as revelations of their own pathogenic phantasies.