In 1916 Freud writes his text “On Transformations of Instinct as Exemplified in Anal Erotism”which he publishes in 1917. As a starting point, he takes the fact that “in the products of the unconscious […] the concepts faeces (money, gift), – baby and penis are ill-distinguished from one another and are easily interchangeable”. From this, he deduces three feminine positions. The first one in which “we not infrequently meet with the repressed wish to possess a penis like a man” the second one in which the place of the wish for a penis “is replaced by the wish for a penis, the frustration of which in real life can lead to the outbreak of neurosis”; the third one in which “both wishes were present in their childhood and that one replaced the other”. The first position, the wish for a penis, in the absence of the conditions of neurosis thereby “changes into the wish for a man […] as an appendage to the penis”. The origin of Freud’s text is “one especially cogent analytical observation” as he says, with a patient who will lead him to formulate the existence of a pregenital organisation which combines sadism and anal erotism. In his second topic, he will qualify this organisation of “drive disunity (the consequence of which will be) […] the preponderant place of the death drive”. Freud constructs a graph from the three positions and our interest is in “the child as a proof of love, as a gift”, that is when he or she is invested in the erotic-anal mode.
This patient of Freud’s, Mrs. H has been the subject of several texts and “The disposition to obsessional neurosis” is the canonical text. Referred by Jung, she was received by Freud at the beginning of November 1908. In May 1911 Freud informed him of his skepticism as to the outcome of the treatment for this serious case which “may be completely untreatable”. Indeed after Freud’s interpretation, transcribed in a letter to Ferenczi in June 1911, and which emphasizes the death drive with regard to her husband, the patient had indeed suddenly turned to Oskar Pfister to go on with her treatment but not without Freud’s accompanying this acting-out, closely keeping in touch with his colleague. Mrs. H. will return. Freud then will duly note the negative therapeutic reaction of his patient to interpretative speech and will go on with the treatment using the gift-speech, “a symbolic gift of speech “such as Lacan qualifies it about the first interviews of Freud with the Rat Man. Meanwhile, another symptomatic behaviour has suddenly emerged, that of being watched 24 hours a day by a live-in nurse.
After several years of marriage, she is 27 and the couple want a child. But her husband announces his impossibility to procreate due to recently diagnosed epididymitis. Mrs. H. breaks down in tears. The symptomatic behaviour then arises to pin (anstecken) her clothes to the sheets of her bed locking herself in them. In the equivocation of the word Ansteckung, Freud identifies the signifier of the infection at work. This collapse, which occurred many years before she addressed him, will lead her to undergo thermal cures. Two other symptoms are also present: the fear of having run over a child while driving her car, and that of finding glass fragments in what she ate. At that time, one could not turn to science for assistance in procreation. Mrs. H. consulted a fortune teller who predicted that she would have two children at the same age as her mother. The satisfaction she will draw from this remains for a long time, which amazes Freud. “Each time that Freud underlines a telepathic fact, […] (notes Lacan), the prediction never came true […] but […] leaves the subject in a state of absolutely fulfilled satisfaction”.
The reputation of psychoanalysis gaining ground in the psychiatric hospitals in Germany, and that of Freud as well, will, years later, prompt Mrs. H’s transference and desire for treatment. Freud links this modality of transference to her “punitive intentions”. In the notes of her nurse in the Bellevue clinic, one can read: “what would have attracted her first of all to psychoanalysis, is that everything was related to the infantile moment and thereby all responsibility for her illness could be withdrawn from her husband and her parents”. Freud will receive her for six years. In the sessions, she expresses her strong guilt, extending her self-reproaches to facts of childhood: a lie, an unfortunate lack of attention when she abandoned her younger sister who was in her care. This delirium of unworthiness which reveals a melancholy position is accompanied by serious symptoms. The medical file shows a washing ceremony which invades the life of the patient. Mrs. H. will spend four stays in that clinic in Bellevue and her last residence will be a hotel accompanied by her nurse.
To give to be
Freud’s 1916 hypothesis of the child as an erotic-anal object is thus to be reinterpreted on the basis of his own advances in the second topic and his remarks published in his correspondence. In a letter to Binswanger, he notes in a dazzling line the psychotic position of Mrs H.: “she also is a woman who wants to help her father like Joan of Arc”. This is really the cause which had pushed her to marry a cousin who was far older than she, but wealthy, allowing her to support her parental family, and her father who was failing in his business. In this series, to help her husband to become a father would be her unconscious position. In this case, as H. Tellenback says, about a melancholy person, “[t]he relationship with the other passes through a service. The thought that his presence alone could make the other happy, or dispose him to recognition, he would defend himself against it ”. To give oneself to/for the other who comes and compensates for what Lacan indicates as the “ego [which] is in the position of rejection from the Ideal Ego”. Another perspective can thus be placed on this other intervention by Freud: he encourages her to collect the dream of her live-in nurse, who fell asleep inadvertently, and he receives her analysis in his text titled “A dream as a means of proof” This live-in nurse who had promised the husband to watch over her 24 hours a day ‘as if she were a child’, innocently told him her dream, thus revealing that she had fallen asleep despite her denials. Thus, Freud places the patient in the position of helping him and psychoanalysis.
What subjective gain from the Cure?
When Mrs. H. entered Binswanger’s clinic in 1916, she expressed to the nursing staff that her guilt had lightened, that she is dependent on a destiny like everybody, the “last concession she would have made to Freud is that she had never sought guilt in herself, but on the side of destiny”, that is to say in a law that is heteronomous to her and that relieves her of her responsibility. This will not be without the persistence of disabling symptoms, as her medical file shows, which will require a life-long medical assistance. Mrs. H. remained in correspondence with Freud, via Binswanger, until her death in April 1938.
Translation: Nadège C.
Proofreanding: Linda Clarke
Photography: ©Hensmans Catho : www.cathohensmans.org
 Freud S. « On Transformations of Instinct as Exemplified in Anal Erotism », The Sexual Life, Paris, PUF, 1982, p.107
 Ibid. p.108
 Ibid. p.107
 Freud S. « The Ego and the Id », Essais de psychanalyse, Paris, Payot, 1985, p.255.
 Freud S. « On Transformations of Instinct as Exemplified in Anal Erotism » op.cit., p.111
 Ibid. p. 112
 It is Mme C in the correspondences with Jung, Mrs. G. in that of Binswanger, Mrs. A. with Abraham and Mrs H. with Pfister. In Ferenczi’s correspondences, she appears as “a thirty-seven-year-old woman”. Read in La Cause Freudienne, n°69, “ A Melancholic Woman : Freud’s Sixth Analysis”, de René Fiori, note 15.
 Freud S., Standard Edition VXII, « The Disposition to Obsessional Neurosis », p317 – 326, Neurosis, psychosis, and perversion, PUF, 1981
 Freud S., Letter to Jung of the 12th of May 1911, Correspondance Freud-Jung, Paris, Gallimard.
 Freud S. Letter to Ferenczi of the 3rd of January 1911, Correspondance Freud-Ferenczi, Paris, Calman-Lévy, 1995
 Lacan J., The Function and Field of Speech and Language, Ecrits, Paris, Seuil, 1966, p.291. Cf Lacan J. « L’étourdit », Autres écrits, Paris, Seuil, 2001, p.491 where this intervention in the case of the Rat Man is formulated as a second node. TRAD
 Lacan J. « Les non-dupes errent », Seminar unpublished, meeting of 20th November 1973.
 Freud S. Lettre to Jung of 8th of November 1908, op. cit.
 Medical Dossier Elfriede Hirschfeld, archives Binwanger, Tübingen, Allemagne.
 Cf. Freud S., « Two Lies told by Children », Neurosis, psychosis et perversion, op. cit.
 Cf. Freud S., « Psychoanalysis and telepathy », results, ideas, problems, II, Paris, PUF, pp. 16-20
 Freud S., Letter to Binswanger of 24th of April 1915, op. cit.
 Tellenbach H. The Melancholic, Paris, PUF, 1979, p.127
 Lacan J., The Seminar, Book V, The Formation of the Unconscious, Paris, Seuil, p.300
 René Fiori already invokes the existence of this text by Freud in an article published in La Cause Freudienne n°69, « A melancholic woman : Freud’s sixth analysis ».
 Medical Dossier, op.cit., 2nd stay, 29th of November, 1922.