I have been referring in my previous remarks, for the most part, to
unravelment of the normal individual's life history. But my remarks are
equally applicable to a mentally disturbed individual's life history and to
the genesis of abnormal psychic states, particularly those to be met with in
the neuroses and psychoneuroses.
So true is the generalization, indeed the truism or dictum here laid down,
that, in only the psychoanalyst knows how many instances, by the analysis of
a single, even the very first dream, one can arrive at the rock-bottom depth
of the trouble at hand--yes, at the very genesis of the condition. It is not
my intention in this paper to report such cases in full detail, since the
presentation of even a single such case would be too lengthy for publication
in an ordinary medical or other journal, and in many instances might well go
to make a good-sized book, a real autobiography of more or less interest, if
not to the average reader, at least to the psychoanalyst and to the person
who has undergone the psychoanalysis. Without attempting to present an
elaborate history or complete analysis, but rather merely to call attention
to the truth of the general problem which is being discussed in this paper,
I shall, however, mention a few definite illustrations of this sort.
A man of sixty was brought to my dispensary clinic by his wife (I say
"brought" and not "accompanied" by his wife, advisedly). She accompanied him
into my examining room. He had an almost complete aphonia, spoke hoarsely
and in a whisper and presented all the signs of abductor laryngeal
paralysis; added to which there was a partial hemiplegia of the right side
involving the upper and lower extremities, but not the face or any of the
cranial nerves other than that supplying the right laryngeal abductor. I
shall not give any other points in the history except that this paralysis
was of four months' duration, there was some resistance to movements at the
elbow and knee, but Babinski and other indications of a central organic
lesion were absent. The results of the rest of the physical examination need
not be mentioned except that the patient presented evidences of
arteriosclerosis. The patient was of dull mentality, meek humble and
subservient; he was much below par mentally (I did not put him through any
special intelligence tests), had little information to offer, constantly
resorted to "I don't know" as a reply, and could co-operate but little. I
did, however, obtain the important bit of information that seventeen years
ago he had had an almost complete aphonia of several weeks' duration and
that one day, while on board ship, he became seasick, vomited, became
frightened, went to his room, and suddenly his voice returned to him. So
sudden was the transformation that many of his fellow-passengers insisted
that he had been deceiving them and had purposely simulated the condition he
had previously presented. The case was one of hysteria, the patient
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