Rat Man - 'Notes Upon A Case of Obsessional Neurosis'

'Notes Upon A Case of Obsessional Neurosis'

The case study was published in 1909 in German. Freud saw the Rat-man patient for some six months, despite later claiming the treatment lasted about a year. He considered the treatment a success.

The patient presented with obsessional thoughts and with behaviors that he felt compelled to carry out, which had been precipitated by the loss/replacement of his pince-nez, and the problem of paying for them, combined with the impact of a story he heard from a fellow officer about a torture wherein rats would eat their way into the anus of the victim. The patient then felt a compulsion to imagine that this fate was befalling two people dear to him, specifically his father and his fiancée. The irrational nature of this obsession is revealed by the fact that the man had the greatest regard for his fiancée and that his revered father had actually been dead for some years. Freud theorized that these obsessive ideas and similar thoughts were produced by conflicts consisting of the combination of loving and aggressive impulses relating to the people concerned - what Eugen Bleuler would later term ambivalence.

The Rat-man also often defended himself against his own thoughts. He had had a secret thought that he wished his father would die so he could inherit all of his money, and become rich enough to marry, before shaming himself by fantasizing that his father would die and leave him nothing. The patient even goes so far as to fantasize about marrying Freud's daughter, believing (Freud writes) that "the only reason I was so kind and incredibly patient with him was that I wanted to have him for a son-in-law" - a matter linked in the transference to his conflicts between his mother's wish for him to marry rich like his father, and his fiancée's poverty.

In addition, the symptoms were believed to keep the patient from needing to make difficult decisions in his current life, and to ward off the anxiety that would be involved in experiencing the angry and aggressive impulses directly. The patient's older sister and father had died, and these losses were considered, along with his suicidal thoughts and his tendency, to form part of the tissue of phantasies, verbal associations and symbolic meanings in which he was trapped.. Freud believed that they had their origin in the Rat Man's sexual experiences of infancy, in particular harsh punishment for childhood masturbation, and the vicissitudes of sexual curiosity.

In the theoretical second part of the case study, Freud elaborates on such defence mechanisms as rationalization, doubt, undoing and displacement.

In a later footnote, Freud laments that although "the patient's mental health was restored to him by the analysis...like so many young men of value and promise, he perished in the Great War.