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A twenty-seven-year-old unmarried woman was in psychoanalysis because of a severe neurosis, the leading symptom of which was erythrophobia. Because of her fears, she was seriously incapacitated in her social relationships as well as in her sexual life, and the prospect of having to remain unmarried, as the result of her symptom, greatly depressed her. The patient left treatment after three years, deeply disheartened, and without having made any progress either in the enlargement of her insight into her psychopathology or in the alleviation of her symptoms.
Eight years later, however, when I inquired into her condition, I received a letter from her that sounded exceedingly happy. Not only had she married; she had had three children, and had been equally successful in other respects that had seemed altogether outside her reach at the time of treatment.
It is rather exceptional for a patient to leave psychoanalytic treatment after three years without having obtained some kind of profit. But it is equally exceptional for even a successful analysis to be followed by a patient's obtaining the fulfillment of practically all her wishes—at least in so far as they can be fulfilled by external events. In this case, it was all the more remarkable in the light of the fact that it apparently came to pass in spite of the persistence of the patient's leading symptom.
A concatenation of events, any one of which occurs only infrequently, makes it worth while to consider in detail the implications of this clinical situation.
The patient was a white, American-born, Protestant woman of New England descent, who sought treatment for shyness, lack of confidence, and severe erythrophobia. The psychological tests that had been made at the request of the referring physician revealed the