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The study of hysterical neurosis has always held special interest, particularly in view of its role in the beginnings of psychoanalysis. The earliest formulations, with subsequent elaborations in Freud's case histories as well as in his theoretical and technical papers, still provide us with the essential guides for our present-day understanding of patients and of treatment techniques.
Even with all of our advances in knowledge about psychic structure, childhood development, ego psychology and psychopathogenesis, some of the basic problems for psychoanalysis remain those which have always been of concern, regarding the applicability of our understanding to the therapeutic task of resolving neurotic difficulties. One of the principal problems along this line is that related to the ego structure which the patient brings to the analytic work, with the limitations imposed by restriction or modification of the ego (Freud, 1937); (A. Freud, 1936); (Eissler, 1953).
The present report will attempt to illustrate the importance of this factor in an analysis, and to trace out the way in which a structural change was eventually brought about. Of interest too will be the details of symptomatology, intrapsychic conflict, predisposing life experience, character of the human struggle with neurosis, and variability and patterning of unconscious fantasy deriving from all genetic levels, which are discernible in the patient's productions. Not of least interest is the portrayal of the way the analytic process unfolds and arrives at those critical turning points when there is a confrontation with the illness system (those modifications of the ego which operate against the motivation for cure, as well as the conflictual processes which constitute the symptomatic neurosis), and an opportunity for a reshaping of the ineffective solutions which have become entrenched. Further, this case does bring out particularly well the importance of real events in a patient's life, and presents an op