The girl's doctor had naturally found no organic basis for her complaints. Nor had the chirologist, brought in from New York; his prescription had been rest and a complete withdrawal from active endeavors, which had almost certainly exacerbated her condition. They had even called in an osteopath, who of course accomplished nothing.
After ruling out the various neurological and orthopaedic possibilities — palsy, Kienbock's lunate disease, and so on — I decided to attempt psychoanalysis. At first I made no headway. The reason was the presence of the girl's mother. No hints were sufficient to induce this good woman to leave doctor and patient to the privacy psychoanalysis requires. After the third visit, I informed the mother that I would not be able to help Priscilla, or indeed to receive her in future as my patient, unless she — the mother — absented herself. Even then I could not at first make Priscilla talk. Following Freud's most recent therapeutic advances, I had her lie down with her eyes closed. I instructed her to think of her paralyzed hand and to say whatever came into her mind in association with this symptom, giving voice to any thoughts that entered her head, no matter what they were, no matter how seemingly irrelevant, inappropriate, or even impolite. Invariably, Priscilla responded only by repeating the most superficial description of the onset of her sufferings.
The critical day, as she always told the story, had been August 10, 1907. She remembered the exact date because it was the day after the funeral of her adored elder sister, Mary, who had been living in Boston with her husband, Bradley. That summer, Mary died of influenza, leaving
Bradley with two infant children to take care of. On the day after the funeral, Priscilla had been charged by her mother with writing acknowledgments to the many friends and relatives who had expressed their condolences. That evening, she experienced sharp pains in her left hand — her writing hand. She saw nothing unusual in this, both because she had written so many letters and because she had felt occasional pain in that hand for the last several years. That night, however, she awoke unable to breathe. When the dyspnea subsided, she tried to go back to sleep but could not. By morning, she was suffering the first of the headaches that would plague her for the next year. Worse, she found her left hand completely paralyzed. And in that condition it had remained, hanging uselessly from her wrist.
These and other such facts she would constantly repeat to me. Long silences would follow. No matter how forcefully I assured her that there was more she wanted to tell me — that it was quite impossible for there to be nothing in her head at all — she steadfastly insisted that she could think of nothing else to say.
I was tempted to hypnotize her. She was plainly a suggestible girl. But Freud had unequivocally rejected hypnosis. It used to be a favored technique, in the early period when he was still working with Breuer, but Freud had discovered that hypnosis was neither lasting in effect nor productive of reliable memory. I decided, however, that I might safely attempt the same technique Freud deployed after abandoning hypnosis. That is what led to the breakthrough.
I told Priscilla that I was going to place my hand on her forehead. I assured her there was a memory that wanted to come out, a memory of central importance to everything she had told me, without which we would understand nothing. I told her that she knew this memory very well, even if she did not know she knew it, and that it would emerge the moment I laid my hand on her forehead.
I did the deed with some trepidation, for I had put my authority at risk. If nothing came of it, I would be in a worse position than I had been before. But in fact the memory did emerge, just as Freud's papers suggested it would, at the very moment Priscilla felt the pressure of my hand against her head. 'Oh, Dr Younger,' she cried out, 'I saw it!'
'What?'
'Mary's hand.'
'Mary's hand?'
'In the coffin. It was terrible. They made us look at her.'
'Go on,' I said.
Priscilla said nothing.
'Was there something wrong with Mary's hand?' I asked.
'Oh no, Doctor. It was perfect. She always had perfect hands. She could play the piano beautifully, not like me.' Priscilla was struggling with some emotion I could not decipher. The color of her cheeks and forehead alarmed me; they were almost scarlet. 'She was still so beautiful. Even the coffin was beautiful, all velvet and white wood. She looked like Sleeping Beauty. But I knew she wasn't asleep.'
'What was it about Mary's hand?'
'Her hand?'
'Yes, her hand, Priscilla.'
'Please don't make me tell you, 'she said. 'I'm too ashamed.'
'You have nothing to be ashamed of. We are not responsible for our feelings; therefore no feeling can cause us shame.'
'Really, Dr Younger?'
'Really.'
'But it was so wrong of me.'
'It was Mary's left hand, wasn't it?' I said at a venture.
She nodded as if confessing a crime.
'Tell me about her left hand, Priscilla.'
'The ring,' she whispered, in the faintest voice.
'Yes,' I said. 'The ring. 'This yes was a lie. I hoped it would make Priscilla think I already understood everything, when in reality I understood nothing. This act of deception was the only aspect of the entire business that I regretted. But I have found myself repeating the same deception, in one form or another, in every psychoanalysis I have ever attempted.
She went on. 'It was the gold ring Brad gave her. And I thought, What a waste. What a waste to bury it with her.'
'There is no shame in that. Practicality is a virtue, not a vice,' I assured her with my usual acuity.
'You don't understand,' she said. 'I wanted it for myself.'
'Yes.'
'I wanted to wear it, Doctor,' she practically shouted. 'I wanted Brad to marry me. Couldn't I have taken care of the poor little babies? Couldn't I have made him happy?' She buried her head in her hands and sobbed. 'I was glad she was dead, Dr Younger. I was glad. Because now he was free to take me.'
'Priscilla,' I said, 'I can't see your face.'
'I'm sorry.'
'I mean I can't see your face because your left hand is covering it.'
She gasped. It was true: she was using her left hand to wipe away her tears. The hysterical symptom had disappeared the instant she regained the memory whose repression caused it. A year has now passed, and the paralysis never recurred, nor the dyspnea, nor the headaches.
Reconstructing the story was simple enough. Priscilla had been in love with Bradley since he first came to call on Mary. Priscilla was then thirteen. I will shock no one, I hope, by observing that a thirteen-year-old girl's love for a young man can include sexual desires, even if not fully understood as such. Priscilla had never admitted to these desires, or to the jealousy she felt toward her sister as a consequence, which irresistibly led in the child's mind to the dreadful but opportunistic thought that, if only Mary were dead, the way would be open for her. All these feelings Priscilla repressed, even from her own consciousness. This repression was doubtless the original source of the occasional pains she felt in her left hand, which probably commenced on the day of the wedding itself, when she first saw the golden ring slipped onto her sister's finger. Two years later, the sight of the ring on Mary's hand in the coffin excited the same thoughts, which very nearly emerged — or perhaps, for a moment, did emerge — into Priscilla's consciousness. But now, in addition to these forbidden feelings of desire and jealousy, there was the utterly impermissible satisfaction she took in her sister's untimely death. The result was a fresh demand for repression, infinitely stronger than the first.