But to what unconscious thought should this chance action, which was made possible through forgetfulness, give expression? The visitor in this case had a very definite relation to my patient and myself. It was she who at one time had recommended me as physician to the suffering girl, and if I am not mistaken my patient considered herself indebted for this advice. Should this halved hundred-dollar note perhaps represent a fee for her mediation? That still remained enigmatic.
But other material was added to this beginning. Several days before a woman mediator of a different sort had inquired of a relative whether the gracious young lady wished to make the acquaintance of a certain gentleman, and that morning, some hours before the woman’s visit, the wooing letter of the suitor arrived, giving occasion for much mirth. When therefore the visitor opened the conversation with inquiries regarding the health of my patient, the latter could well have thought: “You certainly found me the right doctor, but if you could assist me in obtaining the right husband (and a child) I should be still more grateful.”
Both mediators became fused into one in this repressed thought, and she handed the visitor the fee which her fantasy was ready to give the other. This resolution became perfectly convincing when I add that I had told her of such chance or symptomatic actions only the previous evening. She then took advantage of the next occasion to produce an analogous action.
We can undertake a grouping of these extremely frequent chance and symptomatic actions according to their occurrence as habitual, regular under certain circumstances, and as isolated ones. The first group (such as playing with the watch-chain, fingering one’s beard, and so on), which can almost serve as a characteristic of the person concerned, is related to the numerous tic movements, and certainly deserves to be dealt with in connection with the latter. In the second group I place the playing with one’s cane, the scribbling with one’s pencil, the jingling of coins in one’s pocket, kneading dough and other plastic materials, all sorts of handling of one’s clothing, and many other actions of the same order.
These playful occupations during psychic treatment regularly conceal sense and meaning to which other expression is denied. Generally the person in question knows nothing about it; he is unaware whether he is doing the same thing or whether he has imitated certain modifications in his customary playing, and he also fails to see or hear the effects of these actions. For example, he does not hear the noise which is produced by the jingling of coins, and he is astonished and incredulous when his attention is called to it. Of equal significance to the physician, and worthy of his observation, is everything that one does with his clothing often without noticing it. Every change in the customary attire, every little negligence, such as an unfastened button, every trace of exposure means to express something that the wearer of the apparel does not wish to say directly, usually he is entirely unconscious of it.
The interpretation of these trifling chance actions, as well as the proof for their interpretation, can be demonstrated every time with sufficient certainty from the surrounding circumstances during the treatment, from the themes under discussion, and from the ideas that come to the surface when attention is directed to the seeming accident. Because of this connection I will refrain from supporting my assertions by reporting examples with their analyses; but I mention these matters because I believe that they have the same meaning in normal persons as in my patients.
I cannot, however, refrain from showing by at least one example how closely an habitually accomplished symbolic action may be connected with the most intimate and important part of the life of a normal individual.[54]
“As Professor Freud has taught us, the symbolism in the infantile life of the normal plays a greater rôle than was expected from earlier psychoanalytic experiences. In view of this the following brief analysis may be of general interest, especially on account of its medical aspects.
“A doctor on rearranging his furniture in a new house came across a straight, wooden stethoscope, and, after pausing to decide where he should put it, was impelled to place it on the side of his writing-desk in such a position that it stood exactly between his chair and the one reserved for his patients. The act in itself was certainly odd, for in the first place the straight stethoscope served no purpose, as he invariably used a binaural one; and in the second place all his medical apparatus and instruments were always kept in drawers, with the sole exception of this one. However, he gave no thought to the matter until one day it was brought to his notice by a patient who had never seen a wooden stethoscope, asking him what it was. On being told, she asked why he kept it there. He answered in an offhand way that that place was as good as any other. This, however, started him thinking, and he wondered whether there had been an unconscious motive in his action. Being interested in the psychoanalytic method, he asked me to investigate the matter.
“The first memory that occurred to him was the fact that when a medical student he had been struck by the habit his hospital interne had of always carrying in his hand a wooden stethoscope on his ward visits, although he never used it. He greatly admired this interne, and was much attached to him. Later on, when he himself became an interne he contracted the same habit, and would feel very uncomfortable if by mistake he left the room without having the instrument to swing in his hand. The aimlessness of the habit was shown, not only by the fact that the only stethoscope he ever used was a binaural one, which he carried in his pocket, but also in that it was continued when he was a surgical interne and never needed any stethoscope at all.