Part 10

77. Mr. A. W., a manufacturer, 29 years of age, consults me for anxiety, a condition which has already plunged him into very unpleasant situations. His anxiety broke out in Tyrol the first time. He wanted to meet a certain party and asked his landlord for directions. The latter conducted him personally over the road, which was a very rough and badly neglected one. Suddenly the man saw in front of him some suspicious-looking persons. But he controlled himself, although he surmised they were tramps if not a gang of highwaymen. Next he saw a number of men on the hill hurrying in his direction. At that he broke into a run, and kept running as fast as he could. A shot rang out in the distance, intended for him.... He reached the valley, out of breath, and reported the occurrence to the officer. The latter shook his head and did not even care to question the landlord, who explained that he had merely conducted the gentleman through a short cut in the road which is also used by hunters. That short cut leads to the next broad highway. But A. insisted that all was not well and that an attempt had been made to hold him up. The officer said that in his 30-year experience such a thing had never happened in that locality. But A. remained unconvinced and to this day he believes that he had narrowly escaped a hold-up. That might be thought possibly true if the occurrence stood alone. But he had very many such experiences. During a journey through Sweden he saw the hotel proprietor talk in subdued tones in Swedish with a number of guests who thereupon stared at him queerly. There was no key to his room and the room could not be locked. He could not sleep and kept peering through the window. Then he saw a number of queer fellows foregathering in the hall. He could not stay longer in that house. The owner told him that as he had engaged the room he would have to keep it. They could not come to an understanding. He saw an officer passing by and called upon the representative of law to help him extricate himself. The officer knew a few German words, he stepped in, and they went to the police station together, and there a record was made of his remarkable adventures. He left his lodgings a third time on similar grounds. On his excursions he always carries a revolver and that gives him a certain sense of security.

It is easy to diagnose this as a case of paranoia. The absence of insight after the emotional episodes shows the psychotic character of the trouble. A victim of anxiety neurosis may have similar experiences. But afterwards, perhaps only a few hours after the occurrence, he says to himself: “It was nonsense,” and is ashamed to speak of it later. But this man dwells on his adventures trying to convince me of the dangers he has gone through.

The notion of being watched and pursued is a product of his homosexual leaning which he is unable to control. We inquire into his personal habits and past life and find that his mother died when he was very young and his father assumed also the place of a mother to him. With his father he maintained a sort of “spiritual marriage” relationship up to a few months ago. They always went out together, never one without the other, and they slept in one room. The latter habit was but seldom broken by the presence of friends.

A remarkable episode is brought to memory such as is always found among the homosexuals. He once fell in love with a girl, an employee’s sweetheart. That passion soon blew over. Another love affair, however, almost turned him away from his customary leaning. There was another girl employed in the office, a slim, diminutive figure, rather plain-looking, and underdeveloped (a type resembling the male). That girl was engaged and her young man was in the habit of calling to take her home. Everybody in the store knew that the young man was waiting outside at the closing hour (he claims she was cordial also with some other men in the store). He fell in love with the girl and soon showed that uncontrollable passion which is characteristic of homosexuals when they attempt to save themselves from man,—when they try to fly from homosexuality. He soon succeeded in winning her favor against his rival, who was but a poor employee. The poor girl was supremely happy and proud that the wealthy manufacturer’s son had his eye on her. He promptly showed the girl that his intentions were honorable. He withdrew entirely from his father who was bitterly opposed to the affair. He lived with his thoughts exclusively on and for the girl. She had to leave the office. The father requested it and, besides, the other employees gossiped and spread rumors which were unpleasant to him. He received anonymous communications pointing out to him that the girl was flighty. Another employee told him that he had kissed the girl and she was not at all a prude. These persons naturally did not know that their tales only increased his passion for the girl. For it was precisely the thought that she had been kissed by another man that made her so irresistible in his sight. It made him angry and raging mad but his excitation reacted upon his homosexual component. The more he was roused against the girl the more closely he was enmeshed with her. He met her three times daily. He called for her in the morning, at noon they took a walk together, and the evenings, often the nights, belonged to the girl who proved with a physician’s certificate that she was still _virgo intacta_. His relations with her were of such a nature that her virginity was not endangered. This attitude, this fearsome withholding from the task of defloration under the excuse of ethical considerations, is typical of the neurotic’s feeling of uncertainty and lack of confidence in himself, fear of binding himself, and fear of consequences, and shows an insufficient _libido_. The passion was something rather spiritual, a transference, something unreal. For they passed some nights together and he was satisfied merely to be in the same room (they never slept in one bed). Her presence had chiefly a quieting effect on him. Through her he felt himself protected against his homosexual thoughts. He also needed a love affair to show the whole world that he was not homosexual and that he was capable of loving a woman.

But during the very first days of this love affair his jealousy began to assert itself, a peculiarity characteristic of these subjects, permitting them to concentrate their mind perpetually on the subject of men. First he began to investigate her past. She had to confess everything to him. Then there followed endless torture over endless days. In the morning he began to look questioningly at her. If she showed blue dark streaks under her eyes, or looked pale, he felt sure that she had been untrue to him that night. Although he conducted her home late at night and called for her early next morning he still thought that she slipped out of the house to meet some strange lover somewhere. Often he stood on watch all night in the front of her home. He saw curious shadows moving across her window blind and was sure that it must be a man. He endured hellish torments over it. He engaged a detective to watch the girl and caught her in an innocent lie. His persistent questionings had cowed her and sometimes she had to lie in order to pacify him. An innocent fib of that character was the starting point of a quarrel which kept up for many weeks. She saw him patrol up and down in front of her house. He looked badly run down as he did not sleep nights and he neglected his affairs at the factory. She made him promise that he would go home nights. He promised and immediately afterwards felt uneasy over it. For he was certain that she made him give that promise so as to be able to deceive him more easily.

Then terrible thoughts of revenge flashed through his mind. He wanted to shoot the unknown lover and strangle the girl. Perhaps he sought a proof of unfaithfulness so as to get rid of the girl and justify his own disloyalty towards her.

He naturally pretended once to go on a journey only to return unexpectedly to the girl. He thought he smelled cigar smoke, dragged her by the hair, and wanted to force a confession from her. He also accused her of intimacy with her 70-year-old guardian.

Such cases are not favorable for analysis and rather hopeless. I am not as lucky as _Bjerre_[19] to be able to report a complete cure of a case of paranoia. Usually these patients abandon the psychoanalysis, finding some pretext to turn from the consultant. It is useless to explain to them the mechanism of transference. From the moment when they perceive a leaning towards their consultant that sympathetic feeling is changed into anxiety and distrust. They are unwilling to recognize their homosexuality. Their psychic disturbance is too deep and a correction is no longer possible. Often the subjects stay away after only a few visits. This sudden abandonment stands in sharp contrast to their initial enthusiasm for the new method of treatment. Others stay on with the analysis for a few weeks but make little or no progress. So long as their homosexual tendencies are not touched upon, it is possible to keep up the psychoanalysis a little longer but the psychoanalysis is superficial under the circumstances, as they cannot be induced to apply candor, always keep secrets from the consultant, and cover under silence whatever comes into their mind bearing on their attitude towards their physician.

He carried his revolver whenever he called at my office, always ready to shoot down the alleged enemy. I tried to make him understand that he was tortured by his own homosexual and criminal thoughts. He listened incredulously but was not so averse as I have seen most paranoiacs.

This patient also stayed away after three weeks of analysis because the analysis produced in him a tremendous excitement. He thought I was in league with his father[20] to part him from his girl. The real object of his love was the father who seems to me to play an important rôle in the psychogenesis of male paranoia.

I saw him two years later during the war. He had joined the army as volunteer, had made an excellent record for himself and had been slightly wounded. Since the war he felt better. He had given up the engagement shortly after the treatment. His ideas of persecution had subsided to a great extent, he claimed.

The next case shows us a paranoiac jealousy with insane notions based on proofs ferreted out and scrutinized with remarkable ingenuity. Such cases form the borderline towards the class of querrulants who clamor always for their “rights,” precisely because an inner voice clamoring for “injustice” must be drowned.

78. Mr. S. D. is referred to me by his family physician from a distance. I am asked to determine whether his jealousy is justified or the result of a morbid state of mind.

He is a very energetic, active 30-year-old merchant, who conducts the local inn in connection with his larger business in a small village. In eight years he made a great success and attained affluence. He has acquired all the retail business of the place, carries on also a wholesale business with the neighboring retail dealers, and was on the way to become a very wealthy man when he began to quarrel with his wife on account of his jealousy. His wife was of a frigid temperament who always remained cool during his embrace and it always worried him. After the birth of a couple of children she grew somewhat more responsive. When she had her first strong orgasm during his embrace he became suspicious and concluded at once that she must have had some other instructor in the art of love. How was it possible for a cool woman, suddenly, over night, as it were, to turn into a passionate mate? He began watching his wife and came to the conclusion that she must have had intercourse with a certain man possessing a very long _phallus_. There lived in that village a farmer who was no longer young, but wealthy, and known for his long penis and his virility. That fellow was his regular guest at the inn. What more natural than that the innkeeper should conclude that he must be the guilty man. We note that his mind must have been preoccupied for a long time with the size of that man’s penis. That phantasy he projected to his wife. His curiosity and longing to see that _phallus_ he ascribed to his wife. That is how thought processes originate. Such _autism_ (_Bleuler_) renders us uncritical and permits us to see the whole world through the subjective coloring of our own emotions. How could his wife, a woman, fail to be interested in the size of the peasant’s _phallus_, which was openly the talk of the tavern, when he, a man, could not help being interested? Such, approximately, is the logic of this thinking. He began to watch that peasant and his wife. He pretended to go on a journey telling his wife he would not be back before the following day. But he returned that very evening. He tiptoed up the steps to the bedroom. He heard a dull thud. Naturally it was the peasant, escaping through the window. It was—as the woman explained—the cat who had been scared off. He insisted a man had been in the room. His wife felt so indignant that she wanted to leave him at once and refused to say another word. He became humble and begged her imploringly for forgiveness telling her the reason for his jealousy. The wife declared that she had always been passionate but was ashamed to show it. Finally it came to her all of a sudden that it was foolish on her part, also, she had learned to love him more than ever. She cannot help it if she is now more responsive. There followed an interval of peace but only for a few months. Soldiers were quartered in the place and a physically impressive captain secured a room. From the moment of his appearance at the place that captain roused the man’s suspicions. He found that his wife gave the fellow the best cup of coffee, that she was altogether too friendly with him, and that she showered upon him all sorts of pleasant little courtesies. His wife explained to him that this captain bought of them all the supplies for his company and was the means of bringing them important business, and that she was friendly only for business reasons, but that their relations had never trespassed the limits of propriety. But he kept collecting indications of her unfaithfulness. Among the proofs he found the butt of a cigarette in his wife’s room. He questioned her closely and asked the officer’s orderly to bring him a cigarette from his master’s case, claiming those cigarettes had such a pleasant aroma he wanted to try one. He thus secured a cigarette and found that it bore an identical mark. The fact was he smoked the same brand of cigarettes, but he thought he discovered a certain stripe which the other cigarettes did not have (I could not detect the stripe in question). His other proofs were of a like character. This time he had a terrible quarrel with his wife,—much more serious than the previous ordeal. Trouble upon trouble followed after that. He suspected his clerks and dismissed them one after another about every two weeks. Every one was his wife’s lover. Finally he rushed at his wife, in a fit of anger, to beat her, and began choking her. The following day the woman left him, went to live with her sister, and started proceedings for divorce. She claimed her husband was not normal and he voluntarily came to Vienna to place himself under my observation.

First I turned my attention to his jealousy and I tried carefully to correct that. He acknowledged some points, here and there, showed some insight into his condition, and was not shocked when I refused to give him a certificate of good health. Meanwhile he had removed his beard to give himself a younger appearance. That change was not necessary as he was young-looking enough, but it was part of the outbreak of his feminine tendencies. He also had a string of dreams in which he was a woman. Usually he rehearsed the old jealousy scenes and he repeatedly killed his wife in his dreams.

Thus he dreamed:

_I am with my wife in an old room but dressed as a woman, so as not to be recognized. My wife steps out of the room, it was very dark. The captain comes into the room and wants to touch me under the dress. But some one calls him out of the room. I jump at my wife, enraged: that is the kind of a h—— you are. Now I know everything about you ... and I stick a knife in her throat._

In another dream he lies hidden under the bed and feels the swaying motion of coitus above. It was very characteristic that after quarrels and scenes of violence he craved intercourse with his wife and his _libido_ was much stronger ... clearly on account of the sadistic excitation.

I saw this patient again five years after the psychoanalysis. He was divorced from his wife and was apparently very quiet. He claimed to be entirely well, said he was jealous no longer, and every now and then had intercourse with women. I do not dare decide whether this result may be ascribed to the analysis and the therapeutic-educational course of treatment.

The various confusion states, called periodic insanity, must be looked upon as an equivalent of permanent insanity. It is certainly striking to see how many alcoholics, morphinists, opium eaters, cocaine fiends and, in more recent years, victims addicted to adalin, veronal, medinal, luminal, etc., fear insanity. If such a case is analyzed one always finds the homosexual component and the repressed sadistic tendency. The psychic mechanisms of these disorders are the same as those described in the paranoid form of the jealousy delusion. We have in all these cases an endopsychic perception that inner forces compel greater stress on the delusions than on reality.

The next case is a pure example of this condition under a form which often ends in suicide.

79. Mr. O. L., a very talented violinist, suffers unbearable anxieties, among them the fear of insanity being the strongest. He also has hours of terrific, unexplainable depressions for which he is unable to give any cause. He only _has the feeling that he is about to commit some terrible deed_ so as to rid himself of the anxiety and have peace once more. He thinks he might commit some crime and be jailed so as to be sure that there is nothing further for him to fear. During the first weeks he speaks only of his anxiety over his father. He has the idea fixed in his mind that his father will come to Vienna and have him interned in an insane asylum. Rather than put up with that _he will shoot his father first and then kill himself_. He reverts every little while to the suspicion that I am in league with his father. (That is the form which the identification of the physician with the father assumes with this class of patients. The physician is the symbol of the father.) He has been taking various narcotics for a number of years. Not, exactly, to sleep. For he sleeps well without the aid of veronal or pantopon. But he suffers so much of anxiety. And he feels that the narcotics make a better man of him. He uses unbelievable doses of these drugs. He has once taken with suicidal intent 10 g. veronal in one dose with the only result that he slept 24 hours “like a top” and woke up without any ill effects. He sleeps every day till 11 or noon, sometimes into the afternoon hours, and still wakes up somewhat drowsy.

He now abstains strictly from alcohol. He has done a number of foolish things under the influence of drink. Once he tackled an officer at a night resort, wanted to embrace him, kiss him, made various suggestive proposals and finally had to be thrown out. He has also had serious rows which put him in the hands of the police. He gave his word of honor to his father that he would not touch liquor any more because he was threatened with internment at a sanitarium for alcoholics. He broke his word only once but has turned to various narcotics. During a six-months sojourn at a sanitarium he got completely well and abandoned the drugs. One month after leaving the sanitarium he began again to use the drugs.

He is an impressive, handsome, very powerful man, very “lucky” with women. But he is true to none for any length of time excepting the last sweetheart. He did love her and does to this day. He would marry her if he could support her.

He is tremendously jealous and his jealousy is that typical form which is concerned with the past, an example of which we have seen in case 75. He has to be told over and over by his sweethearts how they have been seduced. He must hear with particular circumstantiality all the details of the defloration. That causes him tremendous sexual excitation. Only then is he able to achieve orgasm with women. Otherwise he may keep up the sexual congress for a half hour without accomplishing ejaculation.[21]

Finally ejaculation and orgasm are brought about through manual friction of the penis by the woman. This form of sexual gratification leads back to a particular incident in his youth when the choice was made. First, he confesses that at 17 he maintained relations with a boy who gratified him in that manner. Earlier reminiscences from childhood appear. The incidents always relate to boys. Now he does not want to recognize any homosexual tendencies. At 17 years he made a forceful attempt to tear himself away from his friend and began passionately to run after women and girls.

His homosexuality shows itself in the choice of his love objectives. Usually he seduces the sisters of those of his friends whom he likes in

## particular. I know no affair of his in which some man did not play a

rôle. When a man did not figure at the beginning he was brought in later, so as to complete the constellation necessary for the rousing of his libidinous craving. Very characteristic is the following episode, among the others of the last few years: