Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/2

256 deficient in one respect, namely detailed presentation of the circumstances of anal erotism, so far as they have been elucidated, within the framework of its corresponding clinical entity. Freud alone continues to produce masterly contributions along these lines. I refer to the relevant sections of his papers: 'Bemerkungen über einen Fall von Zwangsneurose' (Sammlung kleiner Schriften zur Neurosenlehre, 3. Folge) and 'Aus der Geschichte einer infantilen Neurose' (Ibid, 4. Folge.)

In both expositions he lets one realize vividly the laborious path of analysis; the new discoveries are seen in the process of being made, and one may guess against what resistances they have been evolved. The following case, which proved to be a severe neurosis erected upon fixation of the anal-erotic components, is to be presented clinically in accordance with this method. I need hardly add that the material examined, which was obtained during the course of some seven months, is certainly lacking in completeness and has not always served to make theoretical relationships clear; meanwhile, however, the treatment had achieved on the one hand recovery of the patient, and on the other a stage at which some significant correlations and discoveries could be established. With due regard to the special features of the case, I will now let the description of the course of the analysis follow. The actual structure of the neurosis naturally only became evident at the conclusion of the treatment; nevertheless in the interests of lucidity I shall not adhere strictly to the chronological method of record, but leaven this with elements of the subsequent synthesis. This is inevitable in any presentation in which elegance is an aim.

J. V., aged thirty-one years, a tramway employee, gave the following account of the onset of his illness. Two and a half years ago he fell off the step of his car at full speed, and was bruised on the head, forearm and loin. All the injuries affected the left side. He lost consciousness, and was conveyed from the scene of the accident to the surgical side of a hospital. In the meantime he regained consciousness, and it was at once evident that the injuries were slight, and only that to the head would