Clinical Communications—A Recovery from the Fear of Blushing1

The fact cannot be too much emphasized that true and permanent recovery from a neurosis is possible only after the patient has brought to consciousness the repressed memories of his early childhood. The mere intellectual understanding of the complexes which he recognizes as dynamically activating his symptoms and character does not furnish emotional insight into the original personal experiences which determine his specific fantasies and their associated ramifications. Effective therapy results only from the lifting of the amnesic veil which envelops the infantile memories, rather than from the patient's correct understanding of the part played by the libidinal and aggressive drives.

This may be illustrated by the case of a man with neurotic character and severe hysterical symptoms, who was completely rehabilitated. The patient came to analysis at the age of thirty-four, because he had suffered from intense blushing for as long as he could remember. This symptom was aggravated at the time of puberty, as many phobias are. If he unexpectedly met an acquaintance in the street, or in a public place or while paying a call, he was seized with a shock-like terror, apparently for no reason at all, and became first livid and then intensely flushed, as though he were terribly ashamed of himself. He had the same reaction whenever he was recognized by someone whom he did not himself know: when, on one occasion, he went to make a purchase and the shopkeeper said "Are you not the son of Mr. So-and-So?", he first became pale and then blushed intensely. If, on the other hand, he knew that the encounter was going to occur, he was able to protect himself inwardly against being frightened. It was torture for him to have to keep his seat in a theater, in a public place or at a dinner, where he was exposed to the gaze of other people. He eagerly sought the company of men of a social position superior to his own, or of sophisticated, free and easy individuals, but he was inhibit