Page:The International Journal of Psycho-Analysis III 1922 1.djvu/26

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l8 KARL ABRAHAM

it also appeared in her dreams with the significance of the once possessed but now lost penis.* As the surgeon happened to be a relative of the patient it was easy for her to connect the 'castra- tion' performed by him associatively with her father.

Among the patient's symptoms which rested on the repression of active castration wishes was a phobia which can be called dread of marriage. This anxiety was expressed in the strongest opposition to the idea of a future marriage, because the patient was afraid 'that she would have to do something terrible to her future husband'. The most difficult part of the analysis was to uncover an extreme refusal of genital erotism, and an extraordi- nary accentuation of mouth erotism in the form of phantasies which appeared compulsively. The idea of oral intercourse was firmly united with that of biting off the penis. This phantasy, which is frequently expressed in anxiety and phenomena of the most varied kinds, was in the present case accompanied by a number of other ideas of a terrifying nature. Psycho-analysis suc- ceeded in removing this abundant production of morbid phantasy.

These kinds of anxiety prevent the person from having inti- mate union with the other sex, and thereby also from carrying out the unconsciously intended 'crime*. The patient is then the only person who has to suffer under those impulses, in the form of permanent abstinence and neurotic anxiety. This assumes a different form as soon as the active castration phantasy has be- come somewhat distorted and thereby unrecognisable to conscious- ness. The modified appearance of the phantasies makes possible stronger effects of these tendencies externally. Such a modification of the active castration tendency can take such a form as that the idea of robbing the man of his genital is abolished and the hostile purpose is displaced from the organ to its function; the aim is now to destroy the potency of the man. The wife's neurotic sexual aversion often has a repelling effect on the man's libido so that a disturbance of potency occurs.

A further modification of the aggressive tendency is expressed in an attitude of the woman to the man that is seen fairly fre- quently and which can be exceedingly painful to him; it is the tendency to disappoint the man. Disappointing signifies to excite

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his appendix.
 * Another patient imag^ed she had a brother and had to remove