Page:The International Journal of Psycho-Analysis III 1922 1.djvu/41

 PLEASURE IN SLEEP AND DISTURBED CAPACITY FOR SLEEP 33

that she did not wish to owe her future husband to the influential position of her father, since no one would marry her for herself. Before she came for analysis she had discovered a kind of anti- dote to the sudden spasm in her throat. Wlien it was impossible for her to avoid going into company the feared attack did not occur if she could manage to place unobserved a piece of dry food, for example, bread, in her mouth, and to swallow it down. If she got over the worst she felt a little relieved and was able to remain. But this means of relief was not reliable and often failed. After three years of an endless and fluctuating struggle against the demon of the neurosis the patient had for a long time become incapable of venturing even one step outside the house without her bread talisman.

The nature of her suffering, a common and well-known one, should not prevent us from apprehending the real state of affairs. The same facts are always confronting us in life; it only depends on our attitude and reflection what deductions we draw from them.

The present case shows the choking reflex as a psychic symptom which bore a number of different meanings, and which, as we might gather from the complaint of the patient, was conditioned by many factors. Its previous history alone proves that it is not a question of a simple globus, but a conversion symptom in which an unusual wealth of affect is condensed. This is the rule in every mono-symptomatic hysteria which after long duration enters into association with the most important experiences of life. We might mention as further characteristics of the symptom, that it settled in the throat like an erectile formation, and that it never produced a disturbance of eating.* The incorporation of a firm object as a

'The patient suffered from an oral libido fixation of unusual dispo- sitional strength which had never abandoned its infantile r61e, and had evoked no reactions. It was for the most part directly attached to the nutritional function ; for she showed a marked pleasure in eating. She liked to suck soup or water slowly; drinking quickly gave her less pleasure. She sometimes licked her plate for a joke; she said she did this like animals. At night a frequent flow of saliva occurred; this phe- nomenon existed in other members of her family. Her father and sister occasionally suffered from nervous vomiting, and a near relative on her father's side was born with a malformation of the palate. In this case therefore archaism of the mouth was marked anatomically as well.