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Some Remarks on a Case of Obsessive-compulsive Neurosis
The case study was published in 1909 in German. Freud saw the Ratman for about a year, and considered the treatment a success.
The patient was presented with obsessional thoughts and with behaviors which he felt compelled to carry out. The thought for which the case received its name was the idea that a torture he had heard about from a military officer having to do with rats eating away at one's body might happen to someone who was dear to him, specifically his father or the woman he admired. Freud theorized that this and similar thoughts were produced by conflicts consisting of the combination of loving and aggressive impulses relating to these people.
The Ratman also often defended himself against his own thoughts. He would have a secret thought that he wished his father would die so he could inherit all of his money, and then he would shame himself by fantasizing that his father would die and leave him nothing. The patient even goes so far as to fantasize about marrying Freud's daughter so that Freud would have more money.
In addition, the symptoms were believed to keep the patient from needing to make difficult decisions in his current life, and to ward off the anxiety which would be involved in experiencing the angry and aggressive impulses directly. The patient's older sister and father had died, and these losses were considered, along with his suicidal thoughts and his tendency to form verbal associations and symbolic meanings.
Freud believed that they began with sexual experiences of infancy, in particular harsh punishment for childhood masturbation, and the vicissitudes of sexual curiosity. In the case study Freud elaborates on his terms 'rationalization', 'doubt', and 'displacement'
In a footnote Freud laments that long term follow-up of this case was not possible, because the patient was killed in World War I.
Rat Man, 77-78, 87-89, 235-238 Ecrits