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18F
Vienna IX, Berggasse 19
19 January 1908
My dear Colleague,
I am answering your letter today especially with the purpose of thanking you for the suggestions you made for my wife and daughter's visit to Berlin. They had to give up this visit, as my daughter became ill on the day before the one fixed for it: feverish with peritoneal symptoms.1 Our doctors concluded that there is an abscess round a stitch that had been left in after her bad appendix operation two years ago. They say her condition is not serious. However, she will probably need an operation.
If, as an experienced senior, I may give you some advice, conduct the psychoanalysis of the O.[ppenheim] patient without a great deal of “sexual displacement” [Sexualverlegung] and without any ambition to impress O. by rapid success. For in the first place it will go better like that, and in the second the case is not suitable for being developed into a show-piece. Such a long-standing obsession in a man nearing the 50s is technically very difficult and therapeutically rather unfavourable. Obsession must be treated early, in persons who are still young, and then the treatment is a triumph and a pleasure. But do not allow [yourself] to be discouraged, and keep the man as long as possible; such patients generally become easily attached and are often satisfied when the physician is not. So far as details are concerned, I shall always tell you what I can divine from a distance, and thus try to compensate for the lack occasioned by the technique not yet having been published in detail. The switch from prayer to atheism is characteristic (typical) of these obsessional neuroses. From the beginning they have to express both contradictory voices, generally in immediate juxtaposition. Hence also their inability to make decisions, because of the equal weight of both sides of the motivation. A patient, for instance,2 sees a stone lying in the roadway and has compulsively to remove it; then it leaves him no peace, and he has to pu