The Analysis of a Boy with a Congenital Deformity

This paper is based on the analysis of Peter, a thirteen-year-old boy born with malformed shoulders and abnormally short arms terminating in hands having only three fingers and no thumbs. When Peter entered analysis, the over-all measurement from his shoulders to fingertips was scarcely eight inches. As far as is known, the psychodynamic implications at the unconscious level of so severe a congenital deformity have not previously been described in psychoanalytic literature. The positive results presented here are to be attributed to the inspiration and close collaboration of the staff of the Hampstead Child-Therapy Clinic under the direction of Anna Freud.

A special objective of the analysis was to compare the castration anxiety associated with such a gross bodily handicap with that of a neurotic youngster having no physical abnormality.

A finding of unusual interest in this analysis was the specific constructive function assumed by the fantasy life in the development of a number of permanent skills—ego abilities.

Much of the information about Peter's family background came from the reports of social workers and Hampstead Clinic personnel