Introduction

Richard was ten years old when I began his analysis.1 His symptoms had developed to such an extent that it had become impossible for him to attend school after the age of eight, when the outbreak of the war in 1939 had increased his anxieties. He was very frightened of other children and this contributed to an increasing avoidance of going out by himself. Moreover, since about the age of four or five, a progressive inhibition of his faculties and interests had been causing great concern to his parents. In addition to these symptoms, he was very hypochondriacal and frequently subject to depressed moods. These difficulties showed themselves in his appearance, for he looked very worried and unhappy. At times, however—and this became striking during analytic sessions—his depression lifted, and then suddenly life and sparkle came into his eyes, completely transforming his face.

Richard was in many ways a precocious and gifted child. He was very musical and showed this at an early age. His love of nature was pronounced, though in its pleasant aspects only. His artistic gifts could be seen, for instance, in the way in which he chose his words and in a feeling for the dramatic which enlivened his conversation. He could not get on with children and was at his best with adults, particularly with women. He tried to impress them by his conversational gifts and to ingratiate himself in a rather precocious way.

Breast-feeding had been unsatisfactory and probably continued only for several weeks.2 He had always been delicate and had suffered from colds and illnesses from infancy onwards.. His mother reported two operations (circumcision at three years and tonsillectomy in his sixth year). Richard was the younger of two children, his brother being about eight years older. His mother, though not ill in a clinical sense, was inclined towards depression. She was very worried about any illness in Richard, and her attitude had some effect on his hypochondriacal fears. There was no doubt t