She had to leave school several times on account of sudden sickness and headache, and was obliged to go to bed. In the morning she sometimes refused to get up and go to school. She suffered from bad dreams, was capricious and not to be counted upon.

I informed the mother, who came to consult me, that these things were neurotic signs, and that some special circumstance must be hidden there, necessitating an interrogation of the child. This supposition was not arbitrary, for every attentive observer knows that if children are restless or in bad temper, there is always something painful worrying them. If it were not painful, they would tell it, and they would not be worried over it. Of course, I am only speaking of those cases having a psychogenic cause. The child confessed to her mother the following story: She had a favorite teacher, of whom she was very fond. During this last term she had fallen back somewhat, through working insufficiently, and she believed she had rather fallen in the estimation of her teacher. She then began to feel sick during his lessons. She felt not only estranged from her teacher, but even somewhat hostile. She directed all her friendly feelings to a poor boy with whom she usually shared the bread which she took to school. Later on she gave him money, so that he could buy bread for himself. In a conversation with this boy she made fun of her teacher and called him a goat. The boy attached himself more and more to her, and considered that he had the right to levy a tax on her occasionally in the form of a little present of money. She now became greatly alarmed lest the boy might tell her teacher that she turned him into ridicule and called him a “goat,” and she promised him two francs if he would give his solemn word never to tell anything to her teacher. From that moment the boy began to exploit her; he demanded money with threats and persecuted her with his demands on the way to school. This made her perfectly miserable. Her attacks of sickness are closely connected with all this story. But after the affair had been disposed of by this confession, her peace of mind was not restored as might have been expected.

We very often see, as I have said, that the mere relation of a painful affair can have an important therapeutical effect. Generally this does not last very long, although on occasion such a favorable effect can maintain itself for a long time. Such a confession is naturally a long way from being an analysis. But there are nerve-specialists nowadays who believe that an analysis is only a somewhat more extensive anamnesis or confession.

A little while later the child had an attack of coughing and missed school for one day. After that she went to school for one day and felt perfectly well. On the third day, a renewed attack of coughing came on, with pains on the left side, fever and vomiting. Her temperature, accurately taken, showed 39.4° C., about 103° F. The doctor feared pneumonia. But the next day everything had passed away. She felt quite well and not the slightest sign of fever or sickness was to be noted.

But still our little patient wept the whole time and did not wish to get up. From this strange course of events I suspected some serious neurosis, and I therefore advised treatment by analysis.

Analytic Treatment

First interview: The little girl seemed to be nervous and constrained, having a disagreeable forced laugh. Miss Moltzer, who analyzed her, gave her first of all an opportunity of talking about her staying in bed. We learn that she liked it immensely, as she always had some society. Everybody came to see her; also her mother read to her out of a book which contained the story of a prince who was ill, but who recovered when his wish was fulfilled, the wish being that his little friend, a poor boy, might be allowed to stay with him.

The obvious relation between this story and her own little love-story, as well as its connection with her own illness, was pointed out to her, whereupon she began to cry and say she would prefer to go to the other children and play with them, otherwise they would run off. This was at once allowed, and away she ran, but came back again, after a short while, somewhat embarrassed. It was explained to her that she did not run away because she was afraid her playmates would go, but that she herself wanted to get off because of resistances.

At the second interview she was less anxious and repressed. They happened to speak about the teacher, but then she was embarrassed. She seemed to be ashamed at the end, and she timidly confessed that she liked her teacher very much. It was then explained to her that she need not be ashamed of that; on the contrary, her love for him could be a valuable stimulus to make her do her very best in his lessons. “So I may love him?” asked the little patient with a happier face.

This explanation justified the child in the choice of the object of her affection. It seems as if she had been ashamed of admitting her feelings for her teacher. It is not easy to explain why this should be so. Our present conception tells us that the libido has great difficulty in taking hold of a personality outside the family, because it still finds itself in incestuous bonds,—a very plausible view indeed, from which it is difficult to withdraw. But we must point out here that her libido was placed with much intensity upon the poor boy, who was also someone outside the family; whence we must conclude that the difficulty was not to be found in the transference of the libido outside the family, but in some other circumstance. The love of the teacher betokens a difficult task; it demands much more than her love for the little boy, which does not require any moral effort on her part. This indication in the analysis that her love for her teacher would enable her to do her utmost brings the child back to her real duty, namely, her adaptation to her teacher.