Fatal Inheritance (21 page)

The patient resists all attempts to unearth the original source of trauma, opposing a consistent attitude of dreamy absent-mindedness to my questions. Her responses are indicative of a deeper resistance than the respect for appearance and manners that has certainly been inculcated into her. No matter how I phrase them, she deflects my questions about sexuality with vague and general remarks. She will not react to any hints and shows no will whatsoever to investigate her deeper self, or, in fact, to be cured of her affliction at all. She will not rise to the bait even if asked whether she does not wish to leave this place and to live outside like other people. She has been here for twenty years now, and any desire to return to the real world has been lost, perhaps replaced by the nameless and unspoken fear of freedom well known in long-term patients and prisoners. She opposes all insistence, even provocation, with a fatalistic sigh.

December 4, 1895

I asked Miss Krieger if she remembered the very beginnings of her condition. She replied that she did remember more or less, but that it had been gradual, not sudden. I asked her to describe these gradual beginnings, and she told me that it had begun at the age of fourteen, after the death of her mother. Until that time, she had been schooled by governesses, and had not experienced any difficulties. She recalls that after her mother died, she occasionally felt a strong desire to write down certain words. Encouraged by friends who were involved in spiritualism, she associated these with the desire of her mother to send her messages from beyond. She had no precise memory of exactly what those first words might have been. At that time, the inner pressure to write down words became increasingly strong, but it took a year before it actually began to interfere severely with her attempts to write other texts. At that point it became necessary for her to keep a second paper near her when writing anything, which she used to note down the irrelevant words that pressed into her mind. Over the course of a second year, she gradually lost the ability to write words of her own choice. She did not recall this development as being particularly unpleasant, and had no sense of being mentally ill. She described it as a person who slowly begins to limp while walking, due to some developing defect of the leg. At first it seems like nothing, and then little by little one accepts the situation without making a fuss about it. For many months, she continued to believe
that she was receiving messages from her defunct mother, but her sister shed doubt upon this idea. This situation continued until the two sisters reached the ages of twenty-two and twenty-four. At that time, the patient’s sister married, and the couple came to the decision, to which the patient did not object, to send her to a clinic in Switzerland specialising in psychiatric treatment of trance and automatic writing. The patient spent four years in Switzerland, returning home only during the summer holidays. Details and records from this clinic have not been provided for use in the present treatment; neither the patient nor her sister consent to speak of it or even to identify it. It is very possible that the treatments she received there provoked a new trauma. I reserve the possibility of discovering more about this at a later stage, if investigation of the original source of trauma does not yield results.

December 18, 1895

I asked the patient if she understood that other people were able to write down anything that they were able to think in their heads. She replied that she
understood this. I asked her if she understood that a person might, at will, take a piece of paper and write a note, for example thanking someone for a gift. We discussed at some length the words ‘Thank you for your kind gift’ and the awkwardness and difficulty caused by the fact of being unable to make such communications by writing. The patient stated that in her youth she had overcome such difficulties by the expedient of dictation, then by the use of the telegraph, and later occasionally even the telephone. She denied that her disability had ever placed her in a position of being unable to behave normally in social situations, or compelled her to be rude. Indeed, she seemed shocked at the suggestion. I asked if it had not made her uncomfortable to be always dependent on her friends and family. She replied that such was the lot of women in our society, and that perhaps, were they granted a general freedom from the yoke of such forced dependence, the psychological effect induced by this freedom would have had some effect upon her own condition. We then entered into a discussion of social mores which convinced me that she is no fool and has a penetrating understanding of the forces and necessities that govern the order of society. Whilst she may deplore, she does not protest, being of a character more attuned to resignation than to rebellion.

 

 

December 31, 1895

Today, I decided to perform a thought experiment with the patient’s collaboration. First, she was
to watch me writing a short thank-you note, simultaneously concentrating on the movements of my arm and hand, and on the words appearing on the page, which she was to read out as they appeared. I concentrated upon the notion of thanks, feeling that expressions of simple courtesy and polite gratefulness were very natural to her, a condition reinforced by careful upbringing and a sense of duty.

Having ascertained that she was able to perform this action with the utmost normality, I set her to a more difficult task, asking her to imagine someone she knew well, her sister, for example, in the process of writing a similar note. Now she was to visualise the situation in detail, imagining each gesture, seeing the pen dipping into the ink and tracing the words. She was then to read out the words just as her imagination caused them to be traced one by one upon the imaginary paper. She was to follow all gestures of arm, hand and pen, just as she had done with me, but entirely in her imagination. This exercise was exactly as successful as the previous one. There could be no distinction between the patient’s performance and that of a perfectly ordinary person. Finally, I asked her to apply the same concentration to envisioning a picture of herself writing the same now-familiar note. I asked her to envision the scene in detail and to describe to me everything that she saw. She appeared to undertake the exercise willingly enough, and described herself moving towards the writing-table, sitting down, drawing the paper in front of her and taking the pen in her hand. She then stopped her description. I encouraged her to continue.
She told me that no sooner was the pen in her hand in her imagination, than the thoughts in her brain began to be taken over by the words which seemingly poured into it from an outside source, and she felt the stirrings of the irresistible compulsion to write them down in an automatic manner, even though there was no actual pen in her hand. As she pronounced the word ‘outside’, she unconsciously pointed her finger towards heaven. She explained that because she felt slightly distanced from the situation of writing due to its being in her imagination and not real, she felt able to slide in and out of the state of trance at will, exactly as though she were opening and shutting her ears to the flow of words. Letting her imagination show her the picture of herself putting pen to paper immediately activated the flow of words, whereas focusing her eyes upon real objects in the room, in particular her own empty hands, brought her back to reality. I asked if she could envision herself writing and pronounce, rather than write, the words that flowed into her mind. She said that this would be possible and indeed she had been aware of the possibility for many years, but that she avoided engaging in the exercise, from a fear of thereby opening a door to the entrance of the trance-words into other aspects of her life than that associated purely with writing. I explained to her that I thought it possible that if the trance-words could be made to intrude into other aspects of ordinary life, then ordinary life could also be induced to arise in moments of trance, and perhaps mingling them would be a positive catalyst for change. She resisted
my suggestion, asserting that she was convinced that trance-words would enter her ordinary life but not the contrary, as the one had always seemed to be within her power and the other not. I very much wished to make the experiment, for I believe that if there is to be any hope of a treatment, some change must be provoked in a situation which has remained static for thirty years, even by somewhat violent means. But the patient refused absolutely, claiming that she has always been aware of the risk of a complete slide into madness, and held it at bay by maintaining a certain mental discipline.

January 7, 1896

Today I decided to make an attempt to break through the patient’s resistance by confronting her directly on one sensitive point that I have chosen to avoid completely until this point: the birth of her child. While obviously unconnected with the original trauma, the source of her troubles, I have reached a stage where I believe that any means must be used to break down the wall she opposes to any penetration into her inner mental life. I reflected at length before coming to this decision and choosing a strategy, and finally decided to ask her point-blank what she could remember of the birth itself.

As I had expected, she was sincerely shocked by
the question, and refused to discuss it in the most absolute terms. Alternating between attitudes of brutality and gentleness, a system that often produces excellent results, I admitted that her attitude was quite understandable, and amended my question to asking whether she actually possessed specific memories of the event itself, without requiring any description. She replied that she did not, as she had been plied with chloroform by the attending physician, and repeated that in any case she would not speak about this. Reverting to the direct approach, I asked her whether she did not wish to know what her child had become. She replied that she did, but that destiny had decided otherwise. I asked if she was even aware now of the child’s age, phrasing the question in a slightly provocative tone, as though to question whether the fact of her own motherhood held any importance for her. She replied quietly that he had just passed his twenty-first birthday, but that it was quite useless my asking her any further information upon the subject, for none had been vouchsafed her and therefore she had none to provide.

I took this moment to explain to the patient that by the very nature of repression, unconnected pieces of repressed knowledge become associated with each other in the unconscious mind, and that by digging forth one such piece of which she had at least some conscious knowledge, I hoped to unearth the other, which was the initial cause of her malady. I said that it might be a painful procedure, analogous in some ways to the extraction of bad teeth, but was
unavoidable if a cure was to be effected. She replied that the project seemed reasonable, but that she had no knowledge on the subject of her child to share with me, repressed or otherwise. I responded that this was certainly untrue, for if nothing else, she must be aware of the identity of the father.

She would not discuss this subject. I developed a thesis upon the notions of social conceptions of morals and honour, and the necessity of rejecting such a system of values in the context of a psychological analysis. She replied that she disagreed, considering that dignity was more important than health. I objected very strongly to this, claiming that a medical operation deprived no one of dignity, and using the example of a purely physical operation to remove something like a tumour located in an intimate place. Would she say that the patient undergoing such an operation had lost his dignity? Was he not, on the contrary, being helped to regain that dignity which illness had partially removed from him? She replied that the doctor’s calling was a noble one, but that the loss of dignity was something which must be felt differently by each individual and that it could be that there were some who would rather die than undergo the operation, and she could not fault them if such were their feelings. As for herself, she would not continue with any discussion on the subject of her past. It was impossible for her to imagine discussing these things with a stranger or with anyone at all apart from God, who alone was and would ever be witness to her memories.

This patient is unfortunately handicapped, in view of any possible treatment, by a sexual repression entirely supported by her social and moral conditioning, which prevents any access to her inner world. The prognosis under these conditions is not hopeful. The patient’s experience with motherhood has not served to increase her conscious self-awareness, but rather, having been so abruptly and perhaps ill-advisedly interrupted, has sealed her even more tightly from any possibility of normal self-expression.