Obsessional neurosis
Sigmund Freud pioneered the exploration of the unconscious mind and in his writing, provides an astoundingly perceptive application of his theories. He entitles one of his most famous case studies, in which the patient has come to be known as the Rat Man, "Notes Upon a Case of Obsessional Neurosis." Freud organizes this paper with clarity and seeming ease, progressing through the individual's treatment and finally applying the results to a general theoretical discussion of the nature of obsessional neurosis. Despite Freud's amazing ability to understand the emotional distress of his patient, he manages to describe the case in a humble way, disclaiming his results as absolute and comprehensive. He begins his text with respect for his patient, saying I cannot give a complete history of the treatment, because that would involve my entering in detail into the circumstances of my patient's life. The importunate interest of a capital city, focussed with particular attention upon my medical activities, forbids my giving a faithful picture of the case (Freud, 1909, p. 2). Amid Freud's sense of decency, he manages to challenge the culture around him with frankness and adept analysis.
In his portrayal of the general characteristics of obsessional neurotics, Freud ties in this particular individual's symptoms to elucidate his ideas and clarify the case study at hand. Freud comments on one such characteristic, the tendency to minimize obsessive thought processes, writing, "our present patient gave an example of this type of behavior...when he attempted to reduce a wish to the level of a mere 'connection of thought (p. 59).'" Freud asserts several other typical characteristics, which this case study supports. He reports that when certain obsessive impulses are uncovered, they disappear rather quickly, but reappear in a distorted form. Such patients also display Freud puts forth the natural progression of this therapy to set up what he terms "the exciting cause of the illness." The issues he Next, Freud outlines a significant portion of the therapy process in which the patient provides some insight into the nature of his behaviors and emotions. One obsessive trait of the Rat Man involved suicidal impulses of which the patient could make no sense. Freud analyzes the material in a manner that helps the patient relate such behavior to defending against his aggressive impulses. He describes a poignant scene in the patient's life in which the Rat Man feels angry that his lady had gone to nurse her ill grandmother. Instead of facing the jealous impulse his conscience found to be unacceptable, he turns his aggression inward, and it is thus expressed as a threat to himself. He feels the constant impulse to cut his own wrists in response to his hostile wish that he could kill his lady's grandmother and thus be reunited with his lover. Freud also outlines many of this individual's other obsessive behaviors, such as his repetitive behavior to protect his lady, or his compulsion to have others repeat information so as not to misunderstand their words. The first, Freud finds, involves a sort of doing and undoing defense! Freud portrays a session, after gaining a deeper level of trust, in which he hears the story of the death of the Rat Man's father and the patient's tremendous guilt over having not been present when his father passed away.
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Approximate Word count = 3152
Approximate Pages = 13 (250 words per page double spaced)
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