Lucy R., Case of

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LUCY R., CASE OF

"Miss Lucy R." is the second case study presented by Freud in Studies on Hysteria (1895d). Lucy was a British governess whom he treated for nine weeks, beginning in December 1882.

Thirty years old, she was being treated by a colleague of Freud's for chronically recurrent suppurative rhinitis. This young English woman of delicate constitution was a governess for the managing director of a factory in the Vienna suburbs. She had recently lost the ability to smell and suffered from depression accompanied by olfactory hallucinations of the smell of "burnt pudding," which Freud immediately identified as the origin of her hysteria.

"I therefore decided to make the smell of burnt pudding the starting point of the analysis," Freud wrote (1895d, p. 107). But the treatment, which should have been short, turned out to be more difficult than expected because the patient, who was working, was unable to see him outside his consulting hours. As a result, he could only devote a few moments of time to her, unlike those patients who were able to make appointments in advance. "We used therefore to break our conversation off short and take up the thread at the same place next time. Miss Lucy R. did not fall into a state of somnambulism when I tried to hypnotize her. I therefore did without somnambulism and conducted her whole analysis while she was in a state which may in fact have differed very little from her normal one" (p. 107).

In his description of Lucy's case, Freud, for the first time, provides a detailed explanation of his new procedure. "When, therefore, my first attempt did not lead either to somnambulism or to a degree of hypnosis involving marked physical changes, I ostensibly dropped hypnosis, and asked only for 'concentration'; and I ordered the patient to lie down and deliberately shut her eyes as a means of achieving this 'concentration.' . . . I decided to start from the assumption that my patients knew everything that was of any pathogenic significance and that it was only a question of obliging them to communicate it" (pp. 109-10). To force this response, "I placed my hand on the patient's forehead or took her head between my hands and said, 'You will think of it under the pressure of my hand. At the moment at which I relax my pressure you will see something in front of you or something will come into your head. Catch hold of it. It will be what we are looking for.—Well, what have you seen or what has occurred to you?' " (p. 110). This procedure, he added, "has scarcely ever left me in the lurch" (p. 111), and all Freud had to do was to tell his patients that it was impossible to fail to extract information from them.

Freud helped Lucy realize that she was in love with the widower whose children she cared for. After his prescribed hydrotherapy treatments failed to have an effect, he was astonished to see her return after the Christmas holidays without any real improvement. Moreover, the smell of burned pudding associated with her hidden love for her employer had been replaced by the smell of cigar smoke.

Freud again applied pressure to her forehead with his hands. Another scene materialized where her employer had scolded her violently for having allowed a female visitor to kiss his children. This scene indicated that she realized he did not love her, and was associated with another scene, this time of the conclusion of a meal and the presence of cigar smoke. This realization resulted in her complete recovery, probably near the end of January 1893.

Freud saw Lucy again in June 1893, when she was in perfect health. He never questioned himself about the cigar smoke. Cigar smoke came up again during Freud's treatment of Dora, for none of his patients was likely to overlook his passion for cigars. Nothing like a transference neurosis can be found in Freud's descriptions of these early treatments, which have little in common with later psychoanalytic therapy. Nonetheless, they are important, aside from the interest in Freud's activity as a therapist, for what they teach us about his theoretical development. With Miss Lucy R., Freud abandoned hypnosis and became certain that his patients possessed an intimate but repressed knowledge of their symptoms. He thus recognized the importance of the means used to overcome patients' resistance to remembering.

Alain de Mijolla

See also: Multilingualism and psychoanalysis; Resistance; Studies on Hysteria .