Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/114

 368 AUGUST STARCKE

observation of sexuality, genital as well as infantile auto-erotic, is radically destroyed by these psychical scotomata, and where ob- servation and registration of sexual factors still take place it is left out of account in working up the materials.

The following example shows how these scotomata hinder the anamnesis. This sexual anamnesis of a male schizophrenic (four reactions negative), aged thirty-five, was obtained by an experien- ced lunacy and nerve specialist.

15. Was the sexual impulse strong or perverse? How did it express itself?

Answer: As usual.

25. What was the nature of your mode of Ufe? (Excesses in love or wine, mental or bodily stress.)

Answer: No excesses. Four years ago the patient had joined a woman abroad, having been previously disillusioned by being in love with a respectable girl who had refused his offer of marriage.

The analyst was able to obtain the following 'additions' by simple questioning.

Excessive masturbation in his youth and recently, once to five times a night. He made his first attempt at coitus on his sister who was about two years his senior when he was fourteen years old. This attempt his sister confirmed. From the age of seventeen onwards he had regular intercourse with prostitutes, gonorrhaea six times, and a lengthy treatment for dilatation of a stricture. Eight years ago he had an ulcer of the penis for which he was treated by injections and drugs for four or five years. Nine years ago he had relations with an actress. He was twice engaged and each time broke it off after a short while. He became depressed after the marriage of his sister.

There was no question of suggestion here, as shown by the confirmation of the incest.

In the methodical registration of stimulus and effect, the facts which show that the stimulus Is also of significance for the im- pulses of the patient are just as methodically ignored. Whether the investigator is a man or a woman, whether he is old or young, whether he has known the patient for some time or not, in a word this whole mass of impulse which as transference and counter-transference psycho-analysis makes the object of the in- vestigation, is lacking in psychiatrical case descriptions. There is