WORD-PLAY IN SYMPTOM-FORMATION
by DOUGLAS BRYAN, London.
A patient during the course of psycho-analytic treatment had once or twice incidentally mentioned to me that at times he had pain in his knee. He told me that it first appeared about two years ago. He woke up one morning in bed and felt a severe pain in his knee which gradually subsided when he got about, but recurred if he walked far or took violent exercise. He had had various kinds of treatment for it, including massage, rest, electricity, and painting with iodine, etc., but he obtained no per- manent relief. The condition of the knee now prevented him from carrying out certain activities, long walks, tennis, etc. When he first told me about the knee he volunteered the statement that he considered it a "psychical knee".
During some months of treatment the knee was only very occasionally mentioned, and then nothing of importance in relation to it was discovered.
One day he spontaneously remarked, "When I was thinking about my knee a day or two ago it reminded me of a prostitute". As I failed to see any connection, I asked him to continue. He said, "I was thinking of my poor knee, and as I said the words
- poor knee'i to myself I pronounced the word 'poor' as 'por',
thus; my por knee, and immediately it flashed into my mind, 'por knee', why that is the Greek for prostitute, TtopVTj".
In order to show the significance of this association I will mention that the patient has never had any sexual relations with women. He has a definite conscious desire to experience sexual relations, but is too inhibited to make any attempt. Further, the idea of intercourse with prostitutes is repugnant to him chiefly on moral grounds.
The pain in the knee seemed to indicate three things. 1. To have a prostitute. "I have a 'por' knee", Ttopvyj. He fulfils the wish for sexual intercourse.
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