Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/11

 A MAN'S UNCONSCIOUS PHANTASY OF PREGNANCY 265

of an hallucinated pregnancy, brought into close relationship with the X-ray episode.^

By this is of course meant an unrecognisable representation, rearranged by the mechanism of the neurosis, to which anal-' erotic components contributed suitable matter (partus per anum). The scene is dominated by a persistent infantile trait. In answer to careful enquiry on the point, the patient told me that when ten years old he had heard the groans and cries of a woman in labour. She was neighbour to the family, and for two whole days was unable to give birth to her child, so that at last the doctor had to deliver her with forceps. He had a vivid recollection of her lying on the bed, and holding her knees drawn up during the pains; he had observed her repeatedly unnoticed through a window. He thought he could remember mo£t clearly seeing the mutilated dead child in a wooden trough. The pain in the loin — a mythological necessity, as it were of the story of the creation, in which Eve is fashioned from Adam's rib — could later be more closely determined by a group of experiences. Nevertheless I am compelled at this point to drop the thread I had taken up, and to interpolate a short description of a nervous intestinal disturbance which the patient had had years ago, and of which the analysis ran parallel to that of the recent illness.

It was in the early years of his marriage, seven years ago, that he had caught a heavy cold at work, which ran its course with high fever. Connected with it after a wearisome convalescence, a peculiar bowel trouble set in. The exact relation between the cold and bowel trouble could not be established, and had it seems not been clear to the doctor treating him at the time. The recent illness indicated that the neurosis tended to develop in connection with an organic process involving pain, in order to break into activity. This suggested the assumption of a maso- chistic fixation, for which the analysis contributed a wealth of

• Later when I first told the patient of this state of affairs, with more adequate evidence, he was silent for a time and then replied: 'Dr. K. told my wife much the same thing when she asked him about my condition. He felt he could not fully envisage my complaints; if only I had not been a man he could have understood me more easily." I must admit that this intuitive confirmation on the part of an unknown colleague, who had thus hit the nail on the head, gave me great satisfaction. Like my predecessor I found of course that this had no effect on the patient at this stage.