Letter 971 Extracts from the Fliess Papers

… I have started on a new case, so I am approaching it without any foregone conclusions. To begin with, of course, everything is fitting together beautifully. He is a young man of twenty-five, who can scarcely walk owing to stiffness of the legs, spasms, tremors, etc. A safeguard against any wrong diagnosis is provided by the accompanying anxiety, which makes him cling to his mother's apron-strings, like the baby that lies hidden behind. The death of his brother and the death of his father in a psychosis precipitated the onset of his condition, which has been present since he was fourteen. He feels ashamed in front of anyone who sees him walking in this way and he regards that as natural. His model is a tabetic uncle, with whom he already identified himself at the age of thirteen on account of the accepted aetiology (leading a dissolute life). Incidentally, he is a regular bear in physique.

Please observe that the shame is merely appended to the symptoms and must relate to other precipitating factors. He volunteered himself that his uncle was in fact not the least ashamed of his gait. The connection between his shame and his gait was a rational one many years ago, when he had gonorrhoea which was naturally noticeable in his gait, and even some years earlier, too, when constant (aimless) erections interfered with his walking. Besides this, the cause of his shame lay deeper. He told me that last year, when they were living on the [river] Wien (in the country), which2 suddenly began to rise, he was seized with a terrible fear that the water would come into his bedroom-that is to say, his room would be flooded, and during the night. Please notice the ambiguity of the expression: I knew he had wetted his bed when he was a child. Five minutes later he told me of his own accord that while he was at school he still regularly wetted his bed and that his mother had threatened that she would come and tell the masters and all the other boys about it. He had felt tremendous anxie