Postscript to the Analysis of a Case of Hysteria

Following the termination of the analysis previously reported, 1 certain developments compelled the patient to seek help once again. What ensued provided important information about the magical expectations upon which the termination had been based, the degree to which the ego modification was still operating, and the further tasks which remained for resolution of the transference neurosis and for working through.

Just nine months after the end of the analysis the patient gave birth to her first child, a son whom she named after the analyst. She breastfed the child for the first week, with considerable gratification, although there was a problem when her nipples became fissured and she had to use breast shields. On the eigth post-partum day, her mother persuaded her to discharge the nurse they had hired, on the grounds that the woman was sloppy and failed to see to it that the patient received ample food supplies. At 4 a.m. that very night, the baby awakened crying. The patient was unable to quiet him by offering the breast, and she experienced the episode as a traumatic event. Her world collapsed in panic, she hated the baby, she wanted to escape, she feared this would mean losing her husband, it was the end of her marriage. Eating and sleeping were impossible, and she was losing weight. Her husband in fact responded with some jibes about supposing she would again need the psychiatrist as a crutch. She was ashamed at having to return, but felt that her whole world depended on it. She dreaded the possibility of my saying I would not see her again or of my not having the time for her. Then there could be no way out but suicide. At the same time she wondered how I could let myself be used like this by patients.

She was coming back now simply to have me help her overcome the state of panic. Though it was difficult, she did begin to tell about her thoughts, and to try to see further meanings. She remembered a dream, in which she took the baby to her breast,