In the first place, this patient commenced by stating that she had no aim in life at all. She had to admit, however, immediately after, that she had at least the aim of wishing to get well, or otherwise she would not have come to me. On being asked why she wished to get well, several subsidiary aims appeared. For the most part, they were rationalization, and I knew these aims would be thrown over in due course, but that, for the purpose in view, did not matter. I told her to go home, and write down her aims, in the manner I have just indicated.
The following was the list brought to me on the next day.
(1) To be well.
(2) To be married.
(3) To become a doctor.
(4) And if I cannot do that, to become a masseuse.
(5) Or a psycho-analyst.
(6) Or a private secretary.
(7) And I should like to have two children.
With this rather pathetic list in front of me, I asked her to give as far as possible the reasons she had for these various wishes, and to examine these on the lines I had indicated, with the following results.
(1) To get well. “The reason for this aim is obvious; it is necessary in order to obtain the others,” said she.
(2) To get married. “This aim has three subsidiary immediate aims,” she replied, “and there may be others. (a) I want a comfortable home of my own, (b) I want satisfaction of my natural instincts in accordance with the custom of ordinary adult life, (c) I could attain the later aim of having two children.” She immediately added, “In that case, the aim of having two children is a remote aim, and if I follow your advice I must no longer have day-dreams about them, I must put them out of my thoughts, I must not waste time on anything connected with them, until I am married.”
(3) To become a doctor. “Concerning this,” she added, “I have always liked studying Zoology, and microscopic work, and diseases. Moreover, it is the only way in which one can make money in a really interesting manner.” She then stated that she realised this to be a double aim, and to consist, firstly, of the aim of earning a livelihood, and secondly, of that of having an interesting occupation. This aim was soon discovered to be phantastic, however, for she had to admit that her financial position would not permit of the necessary study, and that there was no prospect of any improvement in this. She therefore realised that although she had had it at the back of her mind for several months that somehow such an aim might be possible of fulfilment, she now clearly saw that it was not. She at once removed it from the list, and realised that neither regrets nor phantasy in connection with it would be of any avail, and again, that she must bear in mind possibilities and realities.
(4) To become a masseuse. She at once stated her thoughts on this subject. “I have known one or two masseuses, who seem to make money, and who are very happy. Moreover, it is an occupation that a lady can take up.” She then discovered that this involved three aims: (a) to make money, (b) to be happy, (c) to remain genteel. On the opposite side, however, she added that she was not sufficiently physically strong for the work, and was afraid she would soon tire of it, because as an occupation itself, it did not appeal to her. This aim, also, immediately disappeared from the list.