On Changes in Identification from Machine to Cripple

Robert, aged five years and three months, was brought for treatment by his mother because of serious behavior difficulties, insomnia and night terrors which followed a tonsillectomy at the age of three years and eight months. After the operation Robert was, according to the mother, "like in a state of shock, lying in bed for days, still with a blank expression on his face"; he did not respond even to painful stimuli such as pinching or shaking by his mother. Robert himself described the tonsillectomy as follows: "Then the elevator doors closed and I cried and cried and cried. Then the operation was over. Then a few days ago [he meant "after"] I got all blind; then my grandmother carried me in her arms all the time and then I could see again." He ate poorly and whined a great deal. After he developed insomnia and night terrors, he insisted that his mother sleep with him. He was hyperactive and restless, had unprovoked outbursts of rage and destructiveness, alternating with withdrawn behavior in which he did not seem to hear what was said to him. He never played with other children. The immediate reason for seeking treatment was Robert's repeated threats to throw himself down a flight of stairs and to jump out of the window. Once he was found on a window sill ready to jump. He repeatedly played with bobby pins in electric outlets despite warnings, punishments, and burns on both hands.

Robert comes from a broken home. His father left after many quarrels and trial separations, when the child was one year old. One year later, the mother established a common-law relationship with an actor. Robert considers this man his father, and his feelings for