Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/9

 A MAN'S UNCONSCIOUS PHANTASY OF PREGNANCY 263

as conductor. When not yet twenty-four years old he had married a girl, to whom he had previously paid attentions, but whom he had temporarily left in consequence of a quarrel. The marriage was childless although he had longed for a child from its first days.

A clearer conception of the neurosis, and especially of its crucial points, became possible with a knowledge of all these events. Neither dreams hitherto related by the patient nor other indications pointed near the direction of the accident described above; on the other hand a displacement of accent soon took place in connection with the traumatic adventure; not the fall from the car, but to my surprise, the X-ray examination at the hospital advanced more and more indubitably into the forefront. Next it appeared that the patient had repeatedly and obstinately demanded to be X-rayed afresh, giving always as a ratiorfalized justification that his disease (namely the pain in the left side) must be of an organic nature. This stereotyped wish eventually aroused one's suspicion, which led to the following discoveries: The X-ray exam- ination originally arranged by the acting surgeon had been, it appears, of great psychical significance to the patient. Exposed to strange proceedings, he was brought into a state of anxious expectancy even by having to undress in the presence of a doctor, but still more by the various preliminary manipulations untertaken by the latter (such as fixing little sandbags to his extremities in order to keep them still). Now the lamp was switched on and began to work with its loud sparking, and for a moment he felt paralysed with fear. He readily admits that the examination itself rather disappointed him. In his anxiety he had been convinced that the doctor intended performing some operation in connection with the examination — 'perhaps suddenly thrusting an instrument into his loin'. However nothing much happened. The mental process associated with this was naturally entirely withdrawn from the patient's consciousness, and proceeded to develop in the unconscious. The whole adventure thus became a nucleus round which a libidinous wish-phantasy, of a passive-homosexual nature, might crystallise. Moreover the a,ssumption seemed probable that the wish to be X-rayed anew represented not only a persistent unconscious instinctive tendency, but at the same time an attempt at abreaction: a repetition might even now demolish the painful affect and tension which had not been abreacted at the time. So