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STUDY OF A PHOBIA.

By S. E. HOOPER.

I BELIEVE it is held by most Psycho-Analysts that a Phobia is a reaction to a wish that has been repressed because of its incompatibility with the social mind, and that the fear so strongly felt in these cases is really due to the activity of a dissociated complex. This complex threatens to overwhelm the better self, and it is this ever present tension that engenders the fear. It is asserted that a mental shock is insufficient of itself to produce a phobia, although it may play a secondary part. Whilst then the phobia manifests itself as a fear of some external object or event, in reality it is the fear that would result from the unconscious. wish or wishes becoming known.

Another school holds that a phobia is due to certain mental traumata. A body of emotion has been created which continues with the subject as an enduring legacy from past experience. The fear is this body of emotion projected upon some feature of the external world. It is admitted by adherents of this second theory that, as a result of traumata, a group of mental processes may also have become dissociated, which remain as a permanent effect of the experience. The two theories agree in the notion of dissociation: they differ in their conception of the primary cause. The former asserts that it is a repressed wish, the latter attributes the phobia to mental shock. I do not desire in this paper to take any one side in the controversy, realising that it is a matter for experts only with much experience. I prefer to let the facts speak for themselves.

The phobia which is the subject of this paper was one of storms, and later of any strong wind. The victim of this distressing condition, a married lady aged thirty, with one child, had lived for eight years in a semi-tropical climate. The life here was a very lonely one and there were serious difficulties of a financial nature. During the last six months her health gave way and an intense phobia developed. She returned to England a complete wreck and was under medical treatment for a year subsequently, other symptoms being, "Anaemia, weak and irregular heart-action, general weakness, dim eyesight." When I was first introduced to her she told me that her physician had recently pronounced her

organically sound and could not understand why she did not regain her strength. Her fear of storms had gradually extended to include every strong gust of wind, with a sense of panic, of some threat behind the storm, and a fear of Nature itself. I suggested that her phobia might be relieved by the method of psycho-analysis, and she was very eager for me to try to discover the cause of her irrational fear. I then began. a course of analysis.

It will be well at the outset to give a description of the mental state of the subject when in the grip of the phobia.

It began with a sense of unreality and a queer dread of life in general. Later there followed a feeling of divided consciousness which made the mind seem as if it acted in two parts, one an "olive-green devil" that sat apart and mocked, the other a mere recorder of pain. Then came fear. Fear which seized upon the tropical storms, sudden, inevitable, devastating and ever-recurring. I hardly dared to leave the house lest a storm should overtake me, and yet when the storm was about to break I longed to rush out into it, to take the full brunt of it in my teeth, to face it boldly and get the worst over as soon as might be. When I awoke in the morning my first act was to look out of the window to see if any thunder-heads lowered. All day long I watched for them, and when the first distant rumble of thunder was heard a sick dread would steal over me and a sense of panic, growing more and more powerful as the storm approached, until the strain became so unendurable that to seek death at my own hands seemed the only solution. Then after the terrible anticipation was over and the storm had broken, came the helpless trembling and utter exhaustion that sapped my last ounce of courage. At night I feared to go to bed lest a storm should rush upon me in the darkness, feared most of all to undress because that increased the sense of helplessness, feared to sleep lest the terror should steal upon me unawares. There seemed to be something terrible and relentless behind and beyond the storm from the fear of which nothing could ever release me. Life became one infinite torment of suffering, for the terror walked by day and by night and never left me for a moment in peace.

This, I think, gives a vivid enough account of the distressed state of mind of the subject. It will be observed that there arose first a sense of unreality and dread of life in general. This was followed by a feeling of divided personality, and later came the fear of storms. Other points of interest in the description are (a) The longing to rush out into the storm, (b) The dread of undressing and going to bed, (c) The feeling that there was something terrible behind the storm.

ANALYSIS.

It is not possible to give a detailed story of the analysis, but a brief account of one or two of the most significant features in the process will, it is hoped, enable the reader to understand how the constituents of the phobia were discovered.

During the early stages significant memories of her early life came up for discussion. It transpired that her parents were very religious, "with early-Victorian notions of sex"; the mother sympathetic and kind but with no knowledge or wisdom in child-training, the father irritable and without any understanding of children. The subject remarked of herself that she was a lively, high-spirited child, extravagant in affection and with a too vivid imagination, further that she was abnormally sensitive, fainting at the least physical pain.

Her memories up to eight years of age were happy and were chiefly concerned with a brother, one year older than herself, for whom she had a deep devotion. Later impressions of home life were on the whole unhappy. She describes herself as suffering from loneliness and a craving for affection, and states that the atmosphere of her home was unsympathetic. "I repressed all self-expression because my family 'jeered.' The next period, school-days, was happier. The brother returned home from boarding-school and there was renewed companionship. Towards the end of her school life she became very religious. So she grew up to the age of nineteen dreamy and credulous, blind to the facts of life and utterly unpractical, when there occurred a brief but intense love-affair which ended disastrously. The engagement was abruptly broken off, her whole character seemed entirely changed by the experience, and there ensued a reaction for two years to a period of 'wildness.' During these two years she rashly played with fire, taking however good care not to get scorched. Nevertheless she had some narrow escapes, being, on one adventure, half-choked by a man in a fit of anger. "My attitude to all my 'lovers' was always the same, first a brief but strong attraction ending in indifference or active dislike." At twenty-one she was married, spent eight years in the tropics until her health broke down, when she returned home.

As the analysis proceeded there were two dreams which proved of particular significance. The first, which came very soon, a single scene, recalled all the poignant memories of the disastrous love-affair. After this there was a temporary improvement in the symptoms, but in a few days' time the subject relapsed to an even greater panic of storms. Eventually came a dream which proved to be a moving-picture of the subject's whole life, and this furnished an important clue to the understanding of the phobia. On the surface it was just a history of her struggle for freedom of thought in religion. One incident however had much deeper significance and will here be given.

I was undressing in a small shed by the road-side and a man came and reprimanded me for indecency, ordering me to shut the door. I said "There is none or I would have." He however showed it to me, a moving panel that I had not recognised as a door. I shut it, but noticing that the shed was tumbling to pieces, thought matters were not much improved.

The man who accuses the dreamer of wickedness represents orthodox opinion, and the reprimand for indecency was a way of telling her that she might at least keep her opinions to herself "closing the door." But closing the door is of little avail-“truth will out." Orthodoxy apparently is in a bad way, for the shed is tumbling to pieces. Now comes the deeper significance. It suggested to the dreamer in fact that the pleasures of childhood had been dominated by a friendship with a favourite brother. Further analysis recalled many painful experiences and ultimately brought enlightenment in regard to some of the constituents of the phobia. It was decided to probe to the bottom the significance of the 'undressing in a shed' incident. Generally it suggested dressing or undressing under unusual circumstances and the dreamer's own attitude towards it. Her own words were: "I was both surprised and hurt at the accusation of indecency, which is characteristic, for while the sense of shame was implanted in me at a very early age and is kept alive by my husband's attitude in the matter of sex, my natural attitude is one of extreme and even amazing innocence; an innocence which, joined to genuine ignorance, was partly responsible for the trouble which arose between myself and the man I loved. It all hinged on a misunderstanding of this very matter of sex." The incident moreover suggested several occasions of unconventional toilet. One during the "blissful but apprehensive days of my first engagement, one during school-days and one in very early childhood, both with reference to my brother."

When we had reached this stage in the analysis a sudden illumination seemed to come to the subject. "Oh mon dieu," she ejaculated, "It has just occurred to me that the storm symbolises sex. Sudden and fierce, pitiless, remorseless, inevitable-devastating in its effects when thwarted: or just plain troublesome and distracting." She was anxious to follow up this idea and explain how she came to view the matter of sex first with a sense of shame, and later with fear.

of naked savages

First there was a vague memory of a childish game played with her brother. All the subject could remember about this was that she liked the game and wanted to play it, until her brother said it must be played in secret. Then there came a sense of surprise and dismay and she did not want to play it any more. It was the first stirring of shame. Several minor incidents also occurred during early childhood which

gave the child an attitude of distaste, and later of disgust, towards the whole subject of sex. All this time the sense of shame and an apprehension of something indefinite but alarming could be traced growing stronger and stronger.

At the age of fourteen there occurred an incident with the brother which made a profound impression. This brother after various attempts to satisfy his curiosity came into her bedroom one morning and tried to pull off her nightdress. When she protested he assured her that there was no possible harm as he would not touch her, and she, being extremely innocent and ignorant, believed him and thought if it amused him why should it really matter? She was so much devoted to him that there was very little she would not have done for him. But the nightdress was torn, and her mother finding this asked how it happened. Quite readily the girl told the truth. The mother was terribly alarmed, but instead of speaking out made vague references to 'something happening before babies were born.' The girl did not understand in the least and was not sure if she would have a baby next week or not. She was terrified and ashamed, yet could not see wherein she had so greatly sinned. Finally she was told that she must go to confession and confess to the sin of impurity. For a long time after this she suffered agonies of shame and fear and burned with a sense of injustice. The companionship with the brother was temporarily destroyed, but finally she thrust the whole matter out of her thoughts and all but forgot about it. She recalls now however that for years afterwards she would dream from time to time of a quarrel with the brother from which she always awoke in a state of intense anger and with a hatred towards him which took days to wear off.

This was not however all. At the age of sixteen a strange man tried to lure the subject away, frightening and disgusting her very much by his alarming conversation which she did not altogether understand.

Finally at the age of nineteen, still ignorant and wilfully turning away from knowledge because of this sense of shame and fear, she was seized and overwhelmed by love at first sight. The love was reciprocated, but circumstances were all against the lovers. Moreover the subject happened to be staying at the time in a strange and rather disturbing atmosphere amongst people whom she did not understand and with whom she was nervous and unhappy. She was staying with a couple who, as she only discovered later, were not legally married, who used to have violent quarrels, and between whom love seemed to her to be a thing fierce and cruel. As she put it to me, "I felt myself sur