Freud - Complete Works (102 page)

  
¹
[
Footnote added
1914:] This is the
first dream which I submitted to a detailed
interpretation.

The Interpretation Of Dreams

608

DREAM OF JULY 23RD-24TH, 1895

  
A large hall - numerous
guests, whom we were receiving. -Among them was Irma. I at once
took her on one side, as though to answer her letter and to
reproach her for not having accepted my ‘solution’ yet.
I said to her: ‘If you still get pains, its really only your
fault.’ She replied: ‘If you only knew what pains
I’ve got now in my throat and stomach and abdomen - its
choking me’ -I was alarmed and looked at her. She looked pale
and puffy. I thought to myself that after all I must be missing
some organic trouble. I took her to the window and looked down her
throat, and she showed signs of recalcitrance, like women with
artificial dentures. I thought to myself that there was really no
need for her to do that. - She then opened her mouth properly and
on the right I found a big white patch; at another place I saw
extensive whitish grey scabs upon some remarkable curly structures
which were evidently modelled on the turbinal bones of the nose. -
I at once called in Dr. M., and he repeated the examination and
confirmed it . . . . Dr M. looked quite different
from usual; he was very pale, he walked with a limp and his chin
was clean-shaven. . . . My friend Otto was now
standing beside her as well, and my friend Leopold was percussing
her through her bodice and saying: ‘She has a dull area low
down on her left.’ He also indicated that a portion of the
skin on the left shoulder was infiltrated. (I noticed this, just as
he did, in spite of her dress.) . . . M. said
‘There’s no doubt its an infection, but no matter;
dysentery will supervene and the toxin will
eliminated’ . . . We were directly aware, too,
of the origin of her infection. Not long before, when she was
feeling unwell, my friend Otto had given her an injection of a
preparation of propyl, propyls . . . propionic
acid. . . . trimethylamin (and I saw before me the
formula for this printed in heavy type). . . .
Injections of that sort ought not to be made so
thoughtlessly . . . . And probably the syringe had
not been clean.

   This dream has one advantage over
many others. It was immediately clear what events of the previous
day provided its starting-point. My preamble makes that plain. The
news which Otto had given me of Irma’s condition and the case
history which I had been engaged in writing till far into the night
continued to occupy my mental activity even after I was asleep.
Nevertheless, no one who had only read the preamble and the content
of the dream itself could have the slightest notion of what the
dream meant. I myself had no notion. I was astonished at the
symptoms of which Irma complained to me in the dream, since they
were not the same as those for which I had treated her. I smiled at
the senseless idea of an injection of propionic acid and at Dr.
M.’s consoling reflections. Towards its end the dream seemed
to me to be more obscure and compressed than it was at the
beginning. In order to discover the meaning of all this it was
necessary to undertake a detailed analysis.

The Interpretation Of Dreams

609

ANALYSIS

  
The hall - numerous guests
whom we were receiving
. We were spending that summer at
Bellevue, a house standing by itself on one of the hills adjoining
the Kahlenberg. The house had formerly been designed as a place of
entertainment and its reception-rooms were in consequence unusually
lofty and hall like. It was at Bellevue that I had the dream, a few
days before my wife’s birthday. On the previous day my wife
had told me that she expected that a number of friends, including
Irma, would be coming out to visit us on her birthday. My dream was
thus anticipating this occasion: it was my wife’s birthday
and a number of guests, including Irma, were being received by us
in the large hall at Bellevue.

  
I reproached Irma for not
having accepted my solution. I said:
‘
If you still get
pains, it’s your own fault
.’ I might have said this
to her in waking life, and I may actually have done so. It was my
view at that time (though I have since recognized it as a wrong
one) that my task was fulfilled when I had informed a patient of
the hidden meaning of his symptoms: I considered that I was not
responsible for whether he accepted the solution or not - though
this was what success depended on. I owe it to this mistake, which
I have now fortunately corrected, that my life was made easier at a
time when, in spite of all my inevitable ignorance, I was expected
to produce therapeutic successes. -I noticed, however, that the
words which I spoke to Irma in the dream showed that I was
specially anxious not to be responsible for the pains which she
still had. If they were her fault they could not be mine. Could it
be that the purpose of the dream lay in this direction?

The Interpretation Of Dreams

610

  
Irma’s complaint: pains
in her throat and abdomen and stomach; it was choking her
.
Pains in the stomach were among my patient’s symptoms but
were not very prominent; she complained more of feelings of nausea
and disgust. Pains in the throat and abdomen and constriction of
the throat played scarcely any part in her illness. I wondered why
I decided upon this choice of symptoms in the dream but could not
think of an explanation at the moment.

  
She looked pale and puffy
.
My patient always had a rosy complexion. I began to suspect that
someone else was being substituted for her.

  
I was alarmed at the idea that
I had missed an organic illness
. This, as may well be believed,
is a perpetual source of anxiety to a specialist whose practice is
almost limited to neurotic patients and who is in the habit of
attributing to hysteria a great number of symptoms which other
physicians treat as organic. On the other hand, a faint doubt crept
into my mind - from where, I could not tell - that my alarm was not
entirely genuine. If Irma’s pains had an organic basis, once
again I could not be held responsible for curing them; my treatment
only set out to get rid of
hysterical
pains. It occurred to
me, in fact, that I was actually
wishing
that there had been
a wrong diagnosis; for, if so, the blame for my lack of success
would also have been got rid of.

  
I took her to the window to
look down her throat. She showed some recalcitrance, like women
with false teeth. I thought to myself that really there was no need
for her to do that.
I had never had any occasion to examine
Irma’s oral cavity. What happened in the dream reminded me of
an examination I had carried out some time before of a governess:
at a first glance she had seemed a picture of youthful beauty, but
when it came to opening her mouth she had taken measures to conceal
her plate. This led to recollections of other medical examinations
and of little secrets revealed in the course of them - to the
satisfaction of neither party.‘
There was really no need
for her to do that
’ was no doubt intended in the first
place as a compliment to Irma; but I suspected that it had another
meaning besides. (If one carries out an analysis attentively, one
gets a feeling of whether or not one has exhausted all the
background thoughts that are to be expected.) The way in which Irma
stood by the window suddenly reminded me of another experience.
Irma had an intimate woman friend of whom I had a very high
opinion. When I visited this lady one evening I had found her by a
window in the situation reproduced in the dream, and her physician,
the same Dr. M., had pronounced that she had a diphtheritic
membrane. The figure of Dr. M. and the membrane reappear later in
the dream. It now occurred to me that for the last few months I had
had every reason to suppose that this other lady was also a
hysteric. Indeed, Irma herself had betrayed the fact to me. What
did I know of her condition? One thing precisely: that, like my
Irma of the dream, she suffered from hysterical choking. So in the
dream I had replaced my patient by her friend. I now recollected
that I had often played with the idea that she too might ask me to
relieve her of her symptoms. I myself, however, had thought this
unlikely, since she was of a very reserved nature. She was
recalcitrant
, as was shown in the dream. Another reason was
that
there was need for her to do it
: she had so far shown
herself strong enough to master her condition without outside help.
There still remained a few features that I could not attach either
to Irma or to her friend:
pale; puffy; false teeth
. The
false teeth took me to the governess whom I have already mentioned;
I now felt inclined to be satisfied with
bad
teeth. I then
thought of someone else to whom these features might be alluding.
She again was not one of my patients, nor should I have liked to
have her as a patient, since I had noticed that she was bashful in
my presence and I could not think she would make an amenable
patient. She was usually pale, and once, while she had been in
specially good health, she had looked puffy.¹Thus I had been
comparing my patient Irma with two other people who would also have
been recalcitrant to treatment. What could the reason have been for
my having exchanged her in the dream for her friend? Perhaps it was
that I should have
liked
to exchange her: either I felt more
sympathetic towards her friend or had a higher opinion of her
intelligence. For Irma seemed to me foolish because she had not
accepted my solution. Her friend would have been wiser, that is to
say she would have yielded sooner. She would then have
opened
her mouth properly
, and have told me more than Irma.²

  
¹
The still unexplained complaint about
pains in the abdomen
could also be traced back to this third
figure. The person in question was, of course, my own wife; the
pains in the abdomen reminded me of one of the occasions on which I
had noticed her bashfulness. I was forced to admit to myself that I
was not treating either Irma or my wife very kindly in this dream;
but it should be observed by way of excuse that I was measuring
them both by the standard of the good and amenable
patient.

  
²
I had a feeling that the interpretation of
this part of the dream was not carried far enough to make it
possible to follow the whole of its concealed meaning. If I had
pursued my comparison between the three women, it would have taken
me far afield. There is at least one spot in every dream at which
it is unplumbable - a navel, as it were, that is its point of
contact with the unknown.

The Interpretation Of Dreams

611

  
What I saw in her throat: a
white patch and turbinal bones with scabs on them
. The white
patch reminded me of diphtheritis and so of Irma’s friend,
but also of a serious illness of my eldest daughter’s almost
two years earlier and of the fright I had had in those anxious
days. The scabs on the turbinal bones recalled a worry about my own
state of health. I was making frequent use of cocaine at that time
to reduce some troublesome nasal swellings, and I had heard a few
days earlier that one of my women patients who had followed my
example had developed an extensive necrosis of the nasal mucous
membrane. I had been the first to recommend the use of cocaine, in
1885, and this recommendation had brought serious reproaches down
on me. The misuse of that drug had hastened the death of a dear
friend of mine. This had been before 1895.

  
I at once called in Dr. M.,
and he repeated the examination
. This simply corresponded to
the position occupied by M. in our circle. But the ‘
at
once
’ was sufficiently striking to require a special
explanation. It reminded me of a tragic event in my practice. I had
on one occasion produced a severe toxic state in a woman patient by
repeatedly prescribing what was at that time regarded as a harmless
remedy (sulphonal), and had hurriedly turned for assistance and
support to my experienced senior colleague. There was a subsidiary
detail which confirmed the idea that I had this incident in mind.
My patient - who succumbed to the poison - had the same name as my
eldest daughter. It had never occurred to me before, but it struck
me now almost like an act of retribution on the part of destiny. It
was as though the replacement of one person by another was to be
continued in another sense: this Mathilde for that Mathilde, an eye
for an eye and a tooth for a tooth. It seemed as if I had been
collecting all the occasions which I could bring up against myself
as evidence of lack of medical conscientiousness.

The Interpretation Of Dreams

 
612

  
Dr. M. was pale, had a
clean-shaven chin and walked with a limp
. This was true to the
extent that his unhealthy appearance often caused his friends
anxiety. The two other features could only apply to someone else. I
thought of my elder brother, who lives abroad, who is clean-shaven
and whom, if I remembered right, the M. of the dream closely
resembled. We had had news a few days earlier that he was walking
with a limp owing to an arthritic affection of his hip. There must,
I reflected, have been some reason for my fusing into one the two
figures in the dream. I then remembered that I had a similar reason
for being in an ill-humour with each of them: they had both
rejected a certain suggestion I had recently laid before them.