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1 The patient from whose analysis I draw most of my material had had many years of psychotherapy which ended when the therapist advised leucotomy. In view of a shocking family history and the strains to which the patient had been subjected in early childhood the doctor who referred him thought the outlook bad.
2 The patient had a sister 18 months older than himself who died of a disease, from which both suffered, when the patient was one year old; both had severe diarrhoea during the course of the illness.
3 The family associated closely with their neighbours whose children, two girls, one two years younger than my patient, the other seven years younger, were his only playmates until he was ten. The younger died in an asylum before the war; the other still survives but in a state of incurable insanity, supposedly schizophrenia.
4 Disunited parents complicated his childhood. This was spent abroad in a country which was developing its football and other sports, so that when it was discovered that he was an athlete, and intelligent, the way seemed clear for a popular and successful career. But the family fortunes deteriorated and the domestic relationships with them, until at thirteen the boy had had a breakdown from which he made no adequate recovery though he returned to, and has continued in, work. His mother died after years of chronic and painful illness, when he was 17; the father, many years later. His circumstances were further complicated at the time of his mother's death by the need to leave his native land and start afresh here.
5 When he came to me I saw a man of 43, just under 6 feet in height, of wiry build, sallow complexion and dull expressionless features: by profession a teacher. The discussion of his difficulties was
perfunctory, carried on for his part in monosyllabic listlessness. He agreed without enthusiasm to give analysis a trial.
6 My account of the next two years must necessarily be compressed. The central theme of the analysis was contamination