Editing Rat Man (section)

== Freud's write-up: "Notes Upon a Case of Obsessional Neurosis" ==
Freud was led to publish the Rat Man case history because he was feeling pressured to show the world that psychoanalysis could achieve successful therapeutic results. Because the Rat Man previously consulted [[Julius Wagner-Jauregg|Julius von Wagner-Jauregg]], Freud's eminent psychiatric colleague at the [[University of Vienna]], the case was a particularly critical test of Freud's therapeutic abilities. Before October 1908, when he communicated this case history at the first [[International Psychoanalytical Association|International Psychoanalytic Congress]] in [[Salzburg, Austria]], Freud had yet to publish the results of a successful psychoanalysis.

The case study was published in 1909 in Germany. Freud saw the Rat Man patient for some six months despite later claiming the treatment lasted about a year.<ref>Mahony: ''Freud and the Rat Man'', page 69. Yale University Press, 1986</ref> He considered the treatment a success.

The patient presented with [[obsessive–compulsive disorder|obsession]]al thoughts and with behaviors that he felt compelled to carry out,<ref>Freud, p. 39</ref> 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 [[rat torture|torture]] wherein rats would eat their way into the anal cavity of the victim.<ref>Elisabeth Roudinesco, ''Jacques Lacan'' (2005) p. 214-5</ref> 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 been dead for some years.<ref>Freud, p. 48</ref> 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]] later called [[ambivalence]].<ref>Freud, p. 119</ref>

The Rat Man 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"<ref>Freud, p. 80</ref> – 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.<ref>Roudinesco, p. 214-5</ref>

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.<ref name="auto1">Freud, p. 88n</ref> Freud believed that they had their origin in the Rat Man's sexual experiences of infancy, in particular harsh punishment for [[Genital play|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 (psychology)|''rationalization'']], ''doubt'', [[Undoing (psychology)|undoing]] and ''[[displacement (psychology)|displacement]]''.<ref>Freud, 122-8</ref>

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 [[World War I|Great War]]".<ref>Freud, p. 128</ref>

A number of significant discrepancies between the published case history and Freud's process notes, which were discovered among his papers after his death, have been pointed out by Patrick Mahony. According to Mahony, who is an analyst and sympathetic to the general goals of psychoanalysis, Freud's published case history is "muddled" and "inconsistent" on various matters of fact and also exhibits "glaring" omissions of information. In particular, there is an overemphasis on the father to the exclusion of the mother. Mahony states "Freud mixed momentous insights with exaggerated claims," some of which "were made in his zeal to protect and promote a new discipline."<ref>Mahony, Freud and the Rat Man, pp. 32, 34, 216.</ref>