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When I first read Dr. Niederland's paper, I had not followed up on the one gambler I have treated. I have since repaired that lack. In the 15 years since termination of his treatment, he still has not gone back to his gambling.
Without a follow-up, one cannot afford to be dogmatic about a seemingly successful case. It is only with such cases as Freud's Wolf-Man that one can have a really open mind about the contributions of others. Let me then first express what I missed in Dr. Niederland's paper. He did not stress what I had found, in my one patient, to be the core of the psychopathology—the struggle against masturbation, and the content of his unconscious masturbation fantasies.
Not that Niederland could have quoted me, even to rebut my views; for my report has never been published (although I gave it at the New York and the International [in London] meetings, and through a mix-up it was reported in the “International Journal” only in summary). But my findings and conceptualization were all in the classical model, and therefore would be echoed by him. For example, as Nunberg puts it (“Theory of the Therapeutic Results of Psycho-Analysis”), “… the compulsive way in which some patients endeavor to reproduce in constantly repeated actions, in forms of behavior, in fantasies and in symptoms, some excitation through to the end. They can, however, attain neither full satisfaction nor rest so long as the meaning of their actions and fantasies remains unconscious.”
And now for what I have learned—to my great benefit—from Dr. Niederland's paper. It
is what each of us must learn again and again. It is why papers must be written, and should be read. It is the basis of the interminability of each analyst's self-analysis: that unless one is a genius and on the brink of a creative breakthrough, one case does not make a Genus, one technique does not insure an Order, one success does not rule a Kingdom. Each patient differs from every other. Each psychoanalyst, too, has his own p