Brill relates: “While working on the English edition of this book I was obsessed one morning with the strange word ‘Cardillac.’ Busily intent on my work, I refused at first to pay attention to it, but, as is usually the case, I simply could not do anything else. ‘Cardillac’ was constantly in my mind. Realizing that my refusal to recognize it was only a resistance, I decided to analyse it. The following associations occurred to me: Cardillac, cardiac, carrefour, Cadillac.
“Cardiac recalled cardalgia—heartache—a medical friend who had recently told me confidentially that he feared that he had some cardiac affection because he had suffered some attacks of pain in the region of his heart. Knowing him so well, I at once rejected his theory, and told him that his attacks were of a neurotic character, and that his other apparent physical ailments were also only the expression of his neurosis.
“I might add that just before telling me of his heart trouble he spoke of a business matter of vital interest to him which had suddenly come to naught. Being a man of unbounded ambitions, he was very depressed because of late he had suffered many similar reverses. His neurotic conflicts, however, had become manifest a few months before this misfortune. Soon after his father’s death had left a big business on his hands. As the business could be continued only under my friend’s management, he was unable to decide whether to enter into commercial life or continue his chosen career. His great ambition was to become a successful medical practitioner, and although he had practised medicine successfully for many years, he was not altogether satisfied with the financial fluctuations of his professional income. On the other hand, his father’s business promised him an assured, though limited, return. In brief, he was ‘at a crossing and did not know which way to turn.’
“I then recalled the word carrefour, which is the French for ‘crossing,’ and it occurred to me that while working in a hospital in Paris I lived near the ‘Carrefour St. Lazarre.’ And now I could understand what relation all these associations had for me.
“When I resolved to leave the State Hospital I made the decision, first, because I desired to get married, and, secondly, because I wished to enter private practice. This brought up a new problem. Although my State hospital service was an absolute success, judging by promotions and so on, I felt like a great many others in the same situation, namely, that my training was ill suited for private practice. To specialize in mental work was a daring undertaking for one without money and social connections. I also felt that the best I could do for patients should they ever come my way would be to commit them to one of the hospitals, as I had little confidence in the home treatment in vogue. In spite of the enormous advances made in recent years in mental work, the specialist is almost helpless when he is confronted with the average case of insanity. This may be partially attributed to the fact that such cases are brought to him after they have fully developed the psychosis when hospital treatment is imperative. Of the great army of milder mental disturbances, the so-called border-line cases, which make up the bulk of clinic and private work and which rightfully belong to the mental specialist, I knew very little, as those patients rarely, or never, came to the State hospital, and what I did know concerning the treatment of neurasthenia and psychasthenia was not conducive to make me more hopeful of success in private practice.
“It was in this state of mind that I came to Paris, where I hoped to learn enough about the psychoneuroses to enable me to continue my specialty in private practice, and yet feel that I could do something for my patients. What I saw in Paris did not, however, help to change my state of mind. There, too, most of the work was directed to dead tissues. The mental aspects, as such, received but scant attention. I was, therefore, seriously thinking of giving up my mental work for some other specialty. As can be seen, I was confronted with a situation similar to the one of my medical friend. I, too, was at a crossing and did not know which way to turn. My suspense was soon ended. One day I received a letter from my friend Professor Peterson, who, by the way, was responsible for my entering the State hospital service. In this letter he advised me not to give up my work, and suggested the psychiatric clinic of Zurich, where he thought I could find what I desired.
“But what does Cadillac mean? Cadillac is the name of a hotel and of an automobile. A few days before in a country place my medical friend and I had been trying to hire an automobile, but there was none to be had. We both expressed the wish to own an automobile—again an unrealized ambition. I also recalled that the ‘Carrefour St. Lazarre’ always impressed me as being one of the busiest thoroughfares in Paris. It was always congested with automobiles. Cadillac also recalled that only a few days ago on the way to my clinic I noticed a large sign over a building which announced that on a certain day ‘this building was to be occupied by the Cadillac,’ etc. This at first made me think of the Cadillac Hotel, but on second sight I noticed that it referred to the Cadillac motor-car. There was a sudden obstruction here for a few moments. The word Cadillac reappeared and by sound association the word catalogue occurred to me. This word brought back a very mortifying occurrence of recent origin, the motive of which is again blighted ambition.
“When one wishes to report any auto-analysis he must be prepared to lay bare many intimate affairs of his own life. Any one reading carefully Professor Freud’s works cannot fail to become intimately acquainted with him and his family. I have often been asked by persons who claim to have read and studied Freud’s works such questions as: ‘How old is Freud?’ ‘Is Freud married?’ ‘How many children has he?’ etc. Whenever I hear these or similar questions I know that the questioner has either lied when he made these assertions, or, to be more charitable, that he is a very careless and superficial reader. All these questions and many more are answered in Freud’s works. Auto-analyses are autobiographies par excellence; but whereas the autobiographer may for definite reasons consciously and unconsciously hide many facts of his life, the auto-analyst not only tells the truth consciously, but perforce brings to light his whole intimate personality. It is for these reasons that one finds it very unpleasant to report his own auto-analyses. However, as we often report our patients’ unconscious productions, it is but fair that we should sacrifice ourselves on the altar of publicity when occasion demands. This is my apology for having thrust some of my personal affairs on the reader, and for being obliged to continue a little longer in the same strain.
“Before digressing with the last remarks I mentioned that the word Cadillac brought the sound association catalogue. This association brought back another important epoch in my life with which Professor Peterson is connected. Last May I was informed by the secretary of the faculty that I was appointed chief of clinic of the department of psychiatry. I need hardly say that I was exceedingly pleased to be so honoured—in the first place because it was the realization of an ambition which I dared entertain only under special euphoric states; and, secondly, it was a compensation for the many unmerited criticisms from those who are blindly and unreasonably opposing some of my work. Soon thereafter I called on the stenographer of the faculty and spoke to her about a correction to be made in my name as it was printed in the catalogue. For some unknown reason (perhaps racial prejudice) this stenographer, a maiden lady, must have taken a dislike to me. For about three years I repeatedly requested her to have this correction made, but she had paid no attention to me. To be sure she always promised to attend to it, but the mistake remained uncorrected.
“When I saw her last May I again reminded her of this correction, and also called her attention to the fact that as I had been appointed chief of clinic I was especially anxious to have my name correctly printed in the catalogue. She apologized for her remissness and assured me that everything should be as I requested. Imagine my surprise and chagrin when on receiving the new catalogue I found that while the correction had been made in my name I was not listed as chief of clinic. When I asked her about this she was quite puzzled; she said she had no idea that I had been appointed chief of clinic. She had to consult the minutes of the faculty, written by herself, before she was convinced of it. It should be noted that as recorder to the faculty it was her duty to know all these things as soon as they transpired.[75] When she finally ascertained that I was right she was very apologetic and informed me that she would at once write to the superintendent of the clinic to inform him of my appointment, something which she should have done months before. Of course I gained nothing by her regrets and apologies. The catalogue was published and those who read it did not find my name in the desired place. I am chief of clinic in fact but not in name. Moreover, as the appointments are made only for one year, it is quite likely that my great ambition will never be actually realized.