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An office clerk aged 29 who lay in 1938 in the psychiatric department of the Oslo communal hospital with the diagnosis “Neurosis. (Fits of anxiety with obsessions. Sensitive person.)” was sent to a psychoanalyst by the doctor who was treating him.*
The patient who had never heard anything about psychoanalysis now sought for such treatment as a drowning man grasps a straw. At the first visit he gave a harassed, restless impression. He complained that he was inspired by the fear of having to kill somebody, whenever he saw a knife. Moreover, he could not look out of a window in an upper story of a house without feeling the impulse to jump out. He thinks that this compulsive fear first arose when he was in the hospital. The locked windows, to which only the nurse had the key were for him symbolic of his imprisonment. He has long since ceased to go to the cinema, because he is afraid of fainting if some especially thrilling and harrowing scene should be displayed. He believes that onanism and dissipated sexual life are to blame for all this. He had consulted several doctors in order to learn from competent quarters how often in the week one could have sexual intercourse without damage to health. Besides he complained of the fear of becoming insane. His stay in the psychiatric department had further increased his dread in this respect. He stated that the attacks of fear and obsessions had begun a year and a half before, at a time when he was greatly overworked.
The strong unbound anxiety, which arose in connection with the obsessional impulses, showed first of all that it was here a question of genuine obsessions and not a compulsion neurosis, the symptoms of which are free from fear and Ego-alien. The 10-month long analysis of this case developed with a dramatic intensity which led to the disappearance of the obsessions and the actual neurosis connected herewith.
The easily attained removal of the obsessional impulses—as well as some surprising and seemingly characteristic