One Component of the Fear of Death in Early Infancy1

A chance psycho-analytical observation suggested to me that the fear of suffocation might play a considerable part in the earliest development of a child, a part of which we have not seen the significance hitherto. In the case of a young girl who underwent analysis on account of certain intellectual inhibitions, the work led to discussion of the clumsiness she had in general exhibited as a child, and especially to the want of aptitude she had shown in her swimming lessons. Her awkwardness in this came, of course, chiefly from anxiety, which rapidly developed and rose to such a pitch that, for a period, she always vomited on her way to the swimming-bath. In the analysis she clearly recollected that she had always been afraid of drowning. In her associations to this, the danger of being thus suffocated was connected with much earlier occasions on which she had feared suffocation and had shown similar reactions. Recollections of early childhood showed that when drinking milk she had experienced most painful sensations, arising from the forcible compulsion which, owing to her resistance, had always had to be applied, especially by the servants, to make her drink. At first it seemed that perhaps her mouth had once been burnt and that her behaviour arose from fear of a repetition of the injury; but it appeared indubitable that she had every time been threatened by suffocation accompanied by heaving, choking, and difficulty in swallowing. (Even now the smell of warm milk gives her a slight feeling of suffocation in the throat.)

One was compelled to connect this early dread of suffocation with the little schoolgirl's water-phobia by the spontaneity with which unmistakably related material turned up in the analysis. Moreover it was known already, from previous communications of the patient, that many character-traits and later conflicts were due to a strong oral fixation: for example, in the final choice of an occupation (strange as it may seem) certain lines of ment