(a) In former years, when I made more calls at the homes of patients than I do at present, it often happened, when I stood before a door where I should have knocked or rung the bell, that I would pull the key of my own house from my pocket, only to replace it, quite abashed. When I investigated in what patients’ homes this occurred, I had to admit that the faulty action—taking out my key instead of ringing the bell—signified paying a certain tribute to the house where the error occurred. It was equivalent to the thought “Here I feel at home,” as it happened only where I possessed the patient’s regard. (Naturally, I never rang my own door-bell.)
The faulty action was therefore a symbolic representation of a definite thought which was not accepted consciously as serious; for in reality the neurologist is well aware that the patient seeks him only so long as he expects to be benefited by him, and that his own excessively warm interest for his patient is evinced only as a means of psychic treatment.
An almost identical repetition of my experience is described by A. Maeder (“Contrib. à la psychopathologie de la vie quotidienne,” Arch. de Psychol., vi., 1906): “Il est arrivé à chacun de sortir son trousseau, en arrivant à la porte d’un ami particulièrement cher, de se surprendre pour ainsi dire, en train d’ouvrir avec sa clé comme chez soi. C’est un retard, puisqu’il faut sonner malgré tout, mais c’est une preuve qu’on se sent—ou qu’on voudrait se sentir—comme chez soi, auprès de cet ami.”
Jones speaks as follows about the use of keys:[46] “The use of keys is a fertile source of occurrences of this kind, of which two examples may be given. If I am disturbed in the midst of some engrossing work at home by having to go to the hospital to carry out some routine work, I am very apt to find myself trying to open the door of my laboratory there with the key of my desk at home, although the two keys are quite unlike each other. The mistake unconsciously demonstrates where I would rather be at the moment.
“Some years ago I was acting in a subordinate position at a certain institution, the front door of which was kept locked, so that it was necessary to ring for admission. On several occasions I found myself making serious attempts to open the door with my house key. Each one of the permanent visiting staff, of which I aspired to be a member, was provided with a key to avoid the trouble of having to wait at the door. My mistake thus expressed the desire to be on a similar footing and to be quite ‘at home’ there.”
A similar experience is reported by Dr. Hans Sachs of Vienna: “I always carry two keys with me, one for the door of my office and one for my residence. They are not by any means easily interchanged, as the office key is at least three times as big as my house key. Besides, I carry the first in my trouser pocket and the other in my vest pocket. Yet it often happened that I noticed on reaching the door that while ascending the stairs I had taken out the wrong key. I decided to undertake a statistical examination; as I was daily in about the same emotional state when I stood before both doors, I thought that the interchanging of the two keys must show a regular tendency, if they were differently determined psychically. Observation of later occurrences showed that I regularly took out my house key before the office door. Only on one occasion was this reversed: I came home tired, knowing that I would find there a guest. I made an attempt to unlock the door with the, naturally too big, office key.”
(b) At a certain time twice a day for six years I was accustomed to wait for admission before a door in the second story of the same house, and during this long period of time it happened twice (within a short interval) that I climbed a story higher. On the first of these occasions I was in an ambitious day-dream, which allowed me to “mount always higher and higher.” In fact, at that time I heard the door in question open as I put my foot on the first step of the third flight. On the other occasion I again went too far “engrossed in thought.” As soon as I became aware of it, I turned back and sought to snatch the dominating fantasy; I found that I was irritated over a criticism of my works, in which the reproach was made that I “always went too far,” which I replaced by the less respectful expression “climbed too high.”
(c) For many years a reflex hammer and a tuning-fork lay side by side on my desk. One day I hurried off at the close of my office hours, as I wished to catch a certain train, and, despite broad daylight, put the tuning-fork in my coat pocket in place of the reflex hammer. My attention was called to the mistake through the weight of the object drawing down my pocket. Any one unaccustomed to reflect on such slight occurrences would without hesitation explain the faulty action by the hurry of the moment, and excuse it. In spite of that, I preferred to ask myself why I took the tuning-fork instead of the hammer. The haste could just as well have been a motive for carrying out the action properly in order not to waste time over the correction.
“Who last grasped the tuning-fork?” was the question which immediately flashed through my mind. It happened that only a few days ago an idiotic child, whose attention to sensory impressions I was testing, had been so fascinated by the tuning-fork that I found it difficult to tear it away from him. Could it mean, therefore, that I was an idiot? To be sure, so it would seem, as the next thought which associated itself with the hammer was chamer (Hebrew for “ass”).
But what was the meaning of this abusive language? We must here inquire into the situation. I hurried to a consultation at a place on the Western railroad to see a patient who, according to the anamnesis which I received by letter, had fallen from a balcony some months before, and since then had been unable to walk. The physician who invited me wrote that he was still unable to say whether he was dealing with a spinal injury or traumatic neurosis—hysteria. That was what I was to decide. This could therefore be a reminder to be particularly careful in this delicate differential diagnosis. As it is, my colleagues think that hysteria is diagnosed far too carelessly where more serious matters are concerned. But the abuse is not yet justified. Yes, the next association was that the small railroad station is the same place in which, some years previous, I saw a young man who, after a certain emotional experience, could not walk properly. At that time I diagnosed his malady as hysteria, and later put him under psychic treatment; but it afterward turned out that my diagnosis was neither incorrect nor correct. A large number of the patient’s symptoms were hysterical, and they promptly disappeared in the course of treatment. But back of these there was a visible remnant that could not be reached by therapy, and could be referred only to a multiple sclerosis. Those who saw the patient after me had no difficulty in recognizing the organic affection. I could scarcely have acted or judged differently, still the impression was that of a serious mistake; the promise of a cure which I had given him could naturally not be kept.