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The patient I wish to describe presents a rather unusual pathology, which leads to considerable technical difficulties. I have come to the conclusion that in infancy my patient underwent a psychic catastrophe and he has survived it psychically by building a delusional system. Any breach of this defence system threatens my patient with a repetition of the catastrophic situation. This situation of a delusional system as an attempt at recovery following a catastrophic situation up to a point bears out Freud's theory that a delusional system is an attempt at restitution of a destroyed world following a psychic catastrophe (Freud, 1911), (1924a), (1924b). The nature of the catastrophic situation which I think is at the core of my patient's personality is, however, different from Freud's hypothesis of decathexis, and the dynamics of the delusional system have characteristics not covered by Freud's description.
In the first consultation the patient described himself as an obsessional neurotic.1 He said he suffered from severe obsessional ceremonials and from an inability to make up his mind. (How serious the symptoms were I only found out in analysis. For instance, he could take nine or ten hours to get through his ceremonials before going to bed. In the early days of his analysis he once spent 12 hours making up his mind whether it was more efficient to take a bath before work or to do his work first and take his bath after.) He told me that he had spent the past 18 months trying to decide on the choice of the type of analysis and of an analyst. This had been his full-time occupation during that time. He brought with him 12 or 13 sheets of what he called a questionnaire, which he tried to put me through. And, en passant, practically leaving the room, he told me that he was a homosexual—which did not worry him; in fact, he considers heterosexuality rather sissy; but it was very time-consuming and interfered with his efficiency.
The reason he sought treatment, he