On Patients' Gift-Giving

THIS PAPER WILL BE CONFINED to the subject of the receiving of gifts from adult patients during the course of psychoanalysis and analytic psychotherapy. The problem of gifts in relation to child patients is an interesting one deserving full and separate treatment. My discussion will deal with gifts in the common sense meaning of the term, as physical, palpable objects, things, etc. given as a present. The fact that a patient's verbal productions, dreams, secrets, etc. may be unconsciously perceived by him as a "gift" will not be dealt with here.

Freud (1917) remarked early

Those who question this derivation of gifts (from anal instincts and libido) should consider their experience of psychoanalytic treatment, study the gifts they receive as doctors from their patients, and watch the storms of transference which a gift from them can rouse in their patients. (p. 131)

From this it is clear that Freud expected that analysts might from time to time receive gifts from their patients and that they might even, at certain times, present a gift to a patient. In this same paper he noted that, in the unconscious,

The concept faeces (money, gift) baby, and penis are ill-distinguished from one another and easily interchangeable. … For its faeces are the infant's first gift, a part of its body which he will give up only on persuasion by someone he loves, to whom indeed, he will make a spontaneous gift of it as a token of affection. … Defecation affords the first occasion on which the child must decide between a narcissistic and object-loving attitude. He either parts obediently with his faeces, "sacrifices" them to his love, or else retains them for the purposes of auto-erotic satisfaction and later as a means of asserting his own will. (p. 130)

Later (1933) he stated:

We have learnt, then, that after a person's own faeces, his excrement, has lost its value for him this instinctual interest derived from the anal source passes over on to objects that can be presented as gifts.