I might have said this also, or did say it, while awake. At that time I had the opinion (recognised later to be incorrect) that my task was limited to informing patients of the hidden meaning of their symptoms. Whether they then accepted or did not accept the solution upon which success depended—for that I was not responsible. I am thankful to this error, which fortunately has now been overcome, for making life easier for me at a time when, with all my unavoidable ignorance, I was to produce successful cures. But I see in the speech which I make to Irma in the dream, that above all things I do not want to be to blame for the pains which she still feels. If it is Irma's own fault, it cannot be mine. Should the purpose of the dream be looked for in this quarter?
Irma's complaints; pains in the neck, abdomen, and stomach; she is drawn together.
Pains in the stomach belonged to the symptom-complex of my patient, but they were not very prominent; she complained rather of sensations of nausea and disgust. Pains in the neck and abdomen and constriction of the throat hardly played a part in her case. I wonder why I decided upon this choice of symptoms, nor can I for the moment find the reason.
She looks pale and bloated.
My patient was always ruddy. I suspect that another person is here being substituted for her.
I am frightened at the thought that I must have overlooked some organic affection.
This, as the reader will readily believe, is a constant fear with the specialist, who sees neurotics almost exclusively, and who is accustomed to ascribe so many manifestations, which other physicians treat as organic, to hysteria. On the other hand, I am haunted by a faint doubt—I know not whence it comes—as to whether my fear is altogether honest. If Irma's pains are indeed of organic origin, I am not bound to cure them. My treatment, of course, removes only hysterical pains. It seems to me, in fact, that I wish to find an error in the diagnosis; in that case the reproach of being unsuccessful would be removed.
I take her to the window in order to look into her throat. She resists a little, like a woman who has false teeth. I think she does not need them anyway.
