of fifty he finds that some cases react excellently and discusses the meaning of the fact. It turned out that the favourable cases were those in which the neurosis had become manifest in adult years after a normal life had been lived for some time, whereas the results were poor with those patients who had suffered from childhood on. His conclusions may be summed up in his apophthegm that from the point of view of prognosis the age of the neurosis is more important than the age of the neurotic.
Adolph Stern. The Etiology of Neurotic Symptoms in a Child of Eight. New York Medical Journal, May, 22, 1920.
Some very interesting deductions can be drawn from the analysis of this little patient. Among them were the demonstration of the existence in a child of eight of unconscious and precouscious mental processes, which in the adult are usually unconscious. Also like in the findings in the adult neurotic, so in the case of our little patient, those processes were motivating forces of neurotic symptoms, and also factors in the production of character traits. The roots of the neurosis were traceable to the parent complex in its various manifestations. The ambivalent emotions of love and hate, of sadism and masochism, are very evident, especially in reference to the parents, though they are not absent in reference to others in the immediate environment. The infantile sexual curiosity, so regularly found repressed in the adult, is nicely demonstrated in this patient, also for the most part repressed and the source of conflict and symptom formation.
That which in the adult manifests itself as a sense of inferiority can be traced in this patient to two sources, both leading to the narcissistic component. One is that which to the patient indicates that there has been a loss of love for him on the part of the parents, following the birth of a baby brother; and also as belonging to this category, the oft repeated remark of the father that the patient's younger brother is braver and stronger than the patient. The other root of the inferiority feeling arises from the comparison by the patient of the size of his own (small) genitals with that of his father; entering into this category is the frequently repeated threat of the father to cut off the patent's penis if he continued to play with it.
From a technical point of view it is of interest that a transference was very readily established and maintained. A positive transference was present from the start, followed by a well defined negative one, not excessive in character. This is to some extent different from my usual experience with children, in whom the establishing of a transference takes much time. The nature of the transference in no way differed from that in an adult neurotic.
