Page:The International Journal of Psycho-Analysis II 1921 1.djvu/33

 PSYCHO-ANALYTICAL OBSERVATIONS ON TIC 25

idea occurred to me: I fastened a thread to the buttons of my braces, carried it under my waistcoat and finished off the upper end with a small ivory stud which I took between my teeth. The length of the thread was so arranged that I had to bow my head to reach the stud. A splendid trick! — but only for a short time for not only was this position as uncomfortable as it was ridiculous, but also by the contmuous pulling my trousers took on a really grotesque and very embarrassing shape. I had to give up this beautiful idea. However I have always preserved a prediliction for this device and even to-day it often happens on the street that I take the collar of my coat or overcoat between my teeth and so walk along. I have bitten up the border of more than one lapel in that way. At home I do differently : I quickly remove the cravat, unbutton the collar of my shirt and bite into that." In consequence of the raised chin he could no longer see his feet when walking. "So I have to be careful when walking, as I cannot see where I step. I know quite well that in order to remove this discomfort I have only to bend down my eyes or my head, but that is just what I cannot do."

The patient still has: "a certain aversion to looking down," and is also inconvenienced by a "shoulder-crack", "analogous to the sub- luxation of the thumb at will, or the peculiar noises that many people can produce to amuse others". He also produced it as a "small society talent". So long as he was in the society of others, he suppressed his abnormalities, because they made him feel awkward, but "as soon as he was alone he let himself go to his heart's content." "All his tics were let loose, it was an absolute wallow in absurd antics, a motor debauch which eased the patient. He then returned and resumed the interrupted conversation".

His sleeping ceremonials were still more grotesque. "The rubbing of his head on the pillow drove him desperate, he turned himself in every direction to avoid this, at last he selected a re- markable attitude which seemed the most efficacious in obviating his tic : he lay on his side quite at the edge of the bed and let his head hang over."

Before we go into the psycho-analytical meaning of the patient's history we must unfortunately express a doubt whether in this case we are dealing with an actual tic or with a severe obsessional neurosis. The distinction between the ceremonial of an obsessional