The 'Doctor-Game', Illness and the Profession of Medicine

We often see a child playing at being a doctor and we remember games of this sort in our own childhood. Indeed, this game is frequently one of the few memory-traces which survive the infantile amnesia. Freud has stated that this game is 'the repository of the child's ideas about marriage', and this gives it, together with 'playing at father and mother', 'a peculiar importance in the symptomatology of later neuroses'.1 The forbidden coitus- and pregnancy-phantasies of very early childhood appear in a new guise in the features of the game of 'doctor and patient' and in the morally unobjectionable wish to cure or be cured. The sadistic conception of the sexual act is clearly betrayed in the instruments of the little physician: penis-equivalents in the form of make-believe stethoscopes, thermometers, enema-syringes and surgical knives. The illness itself often signifies in more or less disguised form pregnancy in the mother. The 'doctor-game' is frequently combined with the game of 'father and mother', the rôle of sufferer being allotted to a doll which represents children in general. The doll's behaviour is usually a kind of 'negative therapeutic reaction' to the treatment it undergoes; it begins by losing its limbs and finally perishes. It is sacrificed to the castration-complex of its guardians, whom it enables to give play to aggressive tendencies really aimed at their brothers and sisters, the rivals for their parents' love.

Hence, in the 'doctor-game', which is a symbolic form of activity, all the tendencies which enter into the Oedipus conflict find expression. It is a repetition of the primal scene, the child who impersonates the physician identifying himself with the father and the child who acts the patient with the mother.

At first sight it seems curious that children should repeat over and over again (and derive pleasure from the repetition) so painful an experience as that of medical treatment. We know that Freud has taken this circumstance as one