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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]].

See also: Graf, Herbert; Graf, Max; Infantile neurosis; Inhibitions, Symptoms, and Anxiety; Oedipus [[complex]]; [[Phobias in children]]; [[Psychoanalytic Treatment ]] of Children, The.

[[Bibliography]]