Sleep during Psychoanalytic Treatment: Case of Conversion Hysteria

I shall deal with unusual behavior during analysis of an otherwise quite ordinary case. The patient was a thirty-five year old bachelor employed in a bank, the elder of two siblings (sister seven years younger). His mother died when he was twenty-five and his father is now living with the patient's sister.

The patient turned to analysis in 1937 because of difficulty in swallowing. Whenever he tried to swallow a solid piece of food, his throat constricted and he was not able to do so. He became afraid of choking and fell ill two years ago at the age of thirty-three. His material conditions were good. He lived in his own apartment, went about in the society of his friends, had sufficient recreation and relations with unmarried girls. He was a heavy smoker, drank strong black coffee daily and sat in wine cellars until late at night. He was satisfied with his way of life and did not consciously desire any change. A short time before his illness he had an affair with a young, pretty, energetic girl. After this satisfying relationship had lasted a certain time, the girl began to speak about the possibility of marriage. The patient, however, refused it, and soon afterwards left the girl. He said: “My fear of marriage concerned only the boredom of this state, and then I was not able to fall in love. Without love I did not want to get married.” A fragment of the patient's own narrative describes the beginning of his illness: “Once in January, during the evening, I felt a tightening in my throat. It seemed as though I had a foreign body lodged there and I immediately felt anxiety about choking. When the feeling in my throat and the anxiety connected with it did not stop that night I went to see a doctor. However he could not see me so I anxiously went to a first aid station where, after a superficial examination of my throat, the doctor discharged me, saying my pharynx was quite free and there was no danger of choking…. Towards morning I fell asleep but there followed more att