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The patient to be reported on here was treated by me twenty years ago in the paediatric ward of a general hospital. He was then 7 years old, and had the classical symptoms of severe, recurrent ulcerative colitis: anorexia, abdominal cramps, bloody diarrhoea, and high fever. X-rays showed loss of haustras and ulcerations of the large bowel. He was cured of the ulcerative colitis at the age of 8, but his treatment continued until he was 9 years old, and has been reported by me in some detail (Sperling, 1946). I retained contact with the patient and his family until his adolescence, during which time I assisted him on occasions, mainly with problems in school. I knew that he had become interested in snakes and that he kept several snakes in cages in his house as a 'hobby'. It was about this time that our contact broke off.
I saw the patient again when he was 22. He consulted me then because of his 'problems with girls'. I learned that he had been inducted into the armed services and had been overseas. He was a well-built, well-groomed, handsome young man. He told me that he had been well during all these years and had never had any recurrence of the ulcerative colitis. In fact, one of his complaints was that he was constipated, and that he had to watch his diet carefully in order not to gain weight. He seemed to be over-concerned with his appearance and especially with his figure. The most feasible arrangement under the circumstances was psycho-analytic psychotherapy. He stayed in treatment with me for 3½ years.
It soon became apparent that he suffered from a sleep disturbance with frequent nightmares; he had difficulty in falling asleep and would lie awake for hours listening to the noises from his parents' bedroom (which adjoined his own room). If he fell asleep, he would wake up several times in a night in perspiration and would have to get out of bed and take something to eat or drink. In this connexion it may be recalled that, as a young child, prec