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 neuroticsymptoms, 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.
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The question of heredity is referred to, because of the neurotic make-up of the patient's father, and the fact that the later suffered from tabes dorsalis. The author thinks that some of the factors commonly referred to as hereditary may well be environmental in character, in that they influence the child at a very young age, in fact in very early infancy, at a time when children are supposedly not susceptible to neurotic manifestations on the part of the adult. The author believes that in this field lies some hope for prophylaxis in mental disease. Another avenue of approach to prophylaxis in the mental field, lies perhaps in giving accurate and correct instruction to children in fundamental things, like sex, at the time they ask questions, and making the information fit the ability of the child to understand what is told him. What is told him, should be true.