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In this paper I shall discuss a twofold phenomenon I have observed in the treatment of a boy who was my patient from the age of eight to twelve and a half. The phenomenon I am referring to was demonstrated on the one hand in the sudden outbreak of a severe tic and an equally sudden disappearance of its severity; on the other hand, in the transformation of the tic into a paranoid episode.
Both occurrences were apparently closely related to one another, they were once displayed in an oedipal fantasy of unusual forcefulness covering up its pre-oedipal origin. The fantasy mirrored the reality and the conflict of a relationship between father and son, presenting an inverted, latent homosexual, passive oedipal situation.
When the boy was twelve and a half years old, I referred him to a man psychoanalyst, Dr X. In retrospect Dr X.'s communications, on rare informal occasions over the years, have pertinently corroborated my understanding and interpretation of the case.
Edward was referred to me because of his hypermotility. Beyond that, his parents expressed great concern about his speech which they described as being 'not rational'. Without saying so, they apparently referred to the boy's manner of speech as well as to its incoherence. For regardless of its content, the 'motor aspect of speech' (Nagera, 1966), if it is disturbed, indicates the disturbance of an ego function (Hartmann, 1939).
For diagnostic purposes, Edward had been examined by neurologists who did not consider his motility disturbance as pertaining to an organic tic syndrome. The possibility of an underlying schizophrenia, however, had not been excluded (Mahler, 1949). According to the parents there had been great fidgetiness and a generally embarrassing motor behaviour in Edward for at least two years before I saw him. About his earlier history and development, however, I was unable to get the desired information. The parents' description of their son was reminiscent of the type which had been studi