a-general-introduction-to-psychoanalysis-sigmund-freud

There are delusions of the most widely varied content. Why is it that in our
case the content should be jealousy? In what types of persons are obsessions
liable to occur, and, in particular, obsessions of jealousy? We would like to
turn to the psychiatrist with such questions, but here he leaves us in the
lurch. There is only one of our queries which he heeds. He will examine the
family history of this woman and perhaps will give us the answer: "The people
who develop obsessions are those in whose families similar and other psychic
disturbances have repeatedly occurred." In other words, if this lady develops
an obsession she does so because she was predisposed to it by reason of her
heredity. That is certainly something, but is it all that we want to know? Is it
all that was effective in causing this breakdown? Shall we be content to
assume that it is immaterial, accidental and inexplicable why the obsession of
jealousy develops rather than any other? And may we also accept this
sentence about the dominance of the influence of heredity in its negative
meaning, that is, that no matter what experiences came to this human being
she was predestined to develop some kind of obsession? You will want to
know why scientific psychiatry will give no further explanation. And I reply,
"He is a rascal who gives more than he owns." The psychiatrist does not know
of any path that leads him further in the explanation of such a case. He must
content himself with the diagnosis and a prognosis which, despite a wealth of
experience, is uncertain.
Yet, can psychoanalysis do more at this point? Indeed yes! I hope to show
you that even in so inaccessible a case as this it can discover something
which makes the further understanding possible. May I ask you first to note
the apparently insignificant fact that the patient actually provoked the
anonymous letter which now supports her delusion. The day before, she
announces to the intriguing chambermaid that if her husband were to have an
affair with a young girl it would be the worst misfortune that could befall her.
By so doing she really gave the maid the idea of sending her the anonymous
letter. The obsession thus attains a certain independence from the letter; it
existed in the patient beforehand—perhaps as a dread; or was it a wish?
Consider, moreover, these additional details yielded by an analysis of only two
hours. The patient was indeed most helpful when, after telling her story, she
was urged to communicate her further thoughts, ideas and recollections. She
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