Letter from Ludwig Binswanger to Freud, February 5, 1909

5 February 1909

5B

Dear Professor Freud,

Since Herr J. v. T. has now been here for a week, I should like to give you a report on him. First, however, our most cordial thanks for your kindness in referring this patient to us.

I kept the patient in bed for the first few days to make observation easier and also because he was still quite listless and tired. His brother, physician and mother were still visiting him at the time, which only tired him more. During this period, the patient was tremendously selfabsorbed, brooding about his past and future, about his good and bad character traits, about the bad influence his mother had had upon him, about his current ‘neurasthenic’ condition, etc. He said he felt he could never get better, that suicide was the only way out, but that he lacked the courage for it. He would recite his complaints, smiling with weary resignation and avoiding one's eyes. Following your advice, I listened to him patiently. We soon became friends and had some good talks about literature, music, etc., with the result that he quickly grew more responsive.

After the fourth day I let him get up and prescribed a fixed plan of treatment, which he follows scrupulously and which greatly interests him. The patient himself seemed to favour a certain measure of polypragmasy. In this connection I bore in mind your request to let him have his way. At first, he wanted to have electric treatment, something I do not normally undertake more than once a year. I accordingly faradised his back for five minutes each morning. Then he asked for permission to continue taking the glycerophosphate1 Dr. Kauders2 had prescribed for him. In addition he is having light hydropathic treatment and takes two walks every day. He has been given no drugs so far and will not be getting any either. He is so preoccupied with his treatment that he rarely gets down to the cause of his condition. He looks upon his stay here as a means of getting rid of his ‘physical’ lethargy. I do not, of course,