Analysis of a Phobia in a Five-year-old Boy
This important publication of 1909 was the first case study in which clinical material, derived directly from the treatment of a child, was presented as evidence in support of Sigmund Freud's theories of infantile sexuality. The somewhat unorthodox treatment was carried out by the child's father under the "supervision," mainly by way of letters, of Freud himself.
This case study played a significant role for Freud in consolidating his new theories concerning infantile sexuality. While his major findings about the existence of the Oedipus and castration complexes, and the sexual life and theories of children, had originally been derived from the analysis of adults, the case of "Little Hans" (as it has come to be called in the psychoanalytic literature) provided the independent "proof" Freud needed, using clinical material obtained from a child. The case of Little Hans delivered compelling clinical examples which confirmed many of the theoretical statements made in the Three Essays on the Theory of Sexuality, which Freud had published in 1905, and which were, at that time, regarded as scandalous.
Little Hans, whose father had been sending Freud reports about his son's interest in sexual matters and his curiosity about his body and the bodies of others—an interest centered especially upon the anatomical differences between the sexes—suddenly developed a phobia (an infantile neurosis). He refused to leave the house and go into the street for fear of being bitten by a horse. The paper "The Analysis of a Phobia in a Five-Year-Old Boy" is the account of the development, the interpretation, the working through, and partial dissolution of the neurotic conflicts from which the phobic symptom originated. This first "child analysis" was conducted, with "supervision" from Freud, by Max Graf, Hans's father, an early follower of Freud's. His wife, Hans's mother, had been in analysis with Freud, while Graf was a participant in the Society's Wednesday meetings.
Freud had Hans and his father in to see him, and realized that the details of the appearance of the horse that so frightened the boy stood in fact for the eyeglasses and moustache of the father. Freud's revelations prompted Hans to ask his father, "Does the Professor talk to God, as he can tell all that beforehand?" (p. 42-43) Freud indeed played theéminence grise in this story, and the father reported several times to Freud that Hans had requested him to convey this or that fantasy to him, apparently secure in the feeling that "the Professor" would know how to interpret them.
What the case of Little Hans documented were the now well-known elements of the phallic-oedipal phase of sexual development. Evident were the high esteem in which the penis is held by the child as a source of pleasure; the love of the parent of the opposite sex and the rivalry with the (otherwise loved) same sex parent; the pleasures of looking and being looked at; persistent thoughts about the parents' sexual activities, about pregnancy and birth; and jealousy, death wishes, and castration anxiety.
The case study cannot however be seen simply as a description of a specific clinical syndrome or as the extension of analytic technique to children. It also made clear for the first time, as Anna Freud (1980) pointed out, the complexity of the child's emotions and thinking, and graphically illustrated how inner conflicts arise through the mutually contradictory demands of the drives, the developing ego and superego structures, and the external world, and how this process can be accompanied by compromise formations in the form of neurotic symptoms. The paper documents the arduous task for the still immature ego of finding compromise solutions to these conflicts. The publication is also considered to be an important step in closing the gap between pathology and normality, between psychic health and psychic illness.
The case study of "Little Hans" proved to be the forerunner of the development of child analysis (in the work of Anna Freud in Vienna and London and Melanie Klein in Berlin and London) and the direct observation of children.
Freud's explanation of the outbreak of Little Hans's phobia is as follows: the phobic symptom, that a horse might bite him or fall down, was a compromise formation which was developed in an attempt to solve the oedipal conflict, with which he was struggling. Hans's sexually excited attachment to his mother and his ambivalent feelings towards his father, whom he loved deeply, but who stood in his way as a rival for the reciprocation of love from his mother, gave rise to castration anxiety and the fear of being punished, as well as to guilt feelings and to repression. The birth of his sister heightened the conflict as she too was seen by Hans to be a rival for his mother's attention and affection. Hans was able quite openly to express his death wishes towards his sister—but the repression of his aggressive impulses towards his father strengthened his castration anxiety and forced him—through the mechanisms of displacement and externalization—to create a phobic object which could be avoided. In this way Hans's inner conflict was converted into an external danger, which he could escape through flight. He was thus able to ward off an even greater anxiety, that of castration. The development of the phobic symptom fulfilled the function of helping to maintain Little Hans's psychic balance.
* Freud, Sigmund. (1909b). Analyse der Phobie eines fünfjährigen Knaben ("Der kleine Hans") Jb. psychoanal. psycho-pathol. Forsch, I, 1-109; GW, VII, p. 241-377; Analysis of a phobia in a five-year-old boy. SE, 10: 1-149.
* Freud, Anna. (1980). Introduction. In the paperback edition of The analysis of a phobia in a five-year-old boy. Frankfurt am Main: S. Fischer. * Freud, Sigmund. (1905d). Three essays on the theory of sexuality. SE, 7: 123-243. * ——. (1922c). Postscript to "Analysis of a phobia in a five year old boy." SE, 10: 148.