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"Rat Man" was the nickname given by Sigmund Freud to a patient whose 'case history' was published as Bemerkungen ber einen Fall von Zwangsneurose ['Notes Upon A Case Of Obsessional Neurosis'] (1909). The nickname derives from the fact that the patient developed a series of obsessive phantasies in which, In Freud's words, "rats had acquired a series of symbolic meanings, to which...fresh ones were continually being added".[1] To protect the anonymity of patients, psychoanalytic case-studies would usually withhold or disguise the names of the individuals concerned ('Anna O'; 'Little Hans'; 'Wolf Man', etc.). Recent researchers have decided that the "Rat Man" was in fact a clever lawyer named Ernst Lanzer[2] (18781914)though many other sources maintain that the man's name was Paul Lorenz.[3]

'Notes Upon A Case Of Obsessional Neurosis' The case study was published in 1909 in German. Freud saw the Rat-man patient for some six months, despite later claiming the treatment lasted about a year.[4] He considered the treatment a success. The patient presented with obsessional thoughts and with behaviors that he felt compelled to carry out,[5] which had been precipitated by the loss/replacement of his pince-nez, and the problem of paying for them, combined with the impact of a story he heard from a fellow officer about a torture wherein rats would eat their way into the anus of the victim.[6] The patient then felt a compulsion to imagine that this fate was befalling two people dear to him, specifically his father and his fiance. The irrational nature of this obsession is revealed by the fact that the man had the greatest regard for his fiance and that his revered father had actually been dead for some years.[7] Freud theorized that these obsessive ideas and similar thoughts were produced by conflicts consisting of the combination of loving and aggressive impulses relating to the people concerned - what Eugen Bleuler would later term ambivalence.[8] The Rat-man also often defended himself against his own thoughts. He had had a secret thought that he wished his father would die so he could inherit all of his money, and become rich enough to marry, before shaming himself by fantasizing that his father would die and leave him nothing. The patient even goes so far as to fantasize about marrying Freud's daughter, believing (Freud writes) that "the only reason I was so kind and incredibly patient with him was that I wanted to have him for a son-in-law"[9] - a matter linked in thetransference to his conflicts between his mother's wish for him to marry rich like his father, and his fiance's poverty.[10] In addition, the symptoms were believed to keep the patient from needing to make difficult decisions in his current life, and to ward off the anxiety that would be involved in experiencing the angry and aggressive impulses directly. The patient's older sister and father had died, and these losses were considered, along with his suicidal thoughts and his tendency, to form part of the tissue of phantasies, verbal associations and symbolic meanings in which he was trapped.[11]. Freud believed that they had their origin in the Rat Man's sexual experiences of infancy, in particular harsh punishment for childhood masturbation, and the vicissitudes of sexual curiosity. In the theoretical second part of the case study, Freud elaborates on such defence mechanisms as rationalization, doubt, undoing anddisplacement.[12]

In a later footnote, Freud laments that although "the patient's mental health was restored to him by the analysis...like so many young men of value and promise, he perished in the Great War.[13] Influence 1. Jacques Lacan built his early structuralist theory around the Rat Man case, in particular the polarity of father-rich wife/son-poor wife as an intergenerational force creating the individual neurosis.[14] 1. The Rat Man himself cited Nietzsche to Freud to the effect that " 'I did this,' says my Memory.'I cannot have done this,' says my Pride, and remains inexorable. In the end Memory yields".[15] Freud would retell the saying more than once, and it would be taken up by later therapists such as Fritz Perls.[16] 2. Freud's late note upon the Rat Man's acute sense of smell would later be developed into his theory of the process of civilisation and organic repression.[17] Criticism of Freud The only known case in which Freud's notes survive is that of Ernst Lanzer, the Rat-Man, where they exist for the first third of the treatment.[18] Freud treated him for obsessions, particularly the dread that something terrible would happen to his father and his fiance. His fear of rats, Freud showed through elaborate interpretations, was based on disguised anal erotic fantasies.[19] Mr. Stadlen tracked down relatives of Mr. Lanzer who said the account handed down by the family was that Freud had helped him overcome shyness so that he could marry. Peter Gay concluded that "apart from a handful of interesting deviations, the case history Freud published generally followed the process notes he made every night"[20] Patrick Mahony, a psychoanalyst and professor of English at the University of Montreal, has highlighted such discrepancies in his detailed study, Freud and the Rat Man, published in 1986 by the Yale University Press. Dr. Mahony said Freud seems to have consistently implied that the case lasted longer than it actually did.[21] He also said Freud claimed in a lecture to be able to guess the name of the Rat Man's girlfriend, Gisela, from an anagram, Glejisamen, which the patient had invented.[22] Actually, the notes show Freud had learned her name first, and then used it to deduce the meaning of the anagram[23]although in the actual case-study Freud merely states that "when he told it to me, I could not help noticing that the word was in fact an anagram of the name of his lady".[24] Critics have also objected to Freud's downplaying of the role of the Rat Man's mother, and for several deviations on his part from what would later become standard psychoanalytic practice.[25] THE TREATMENT Mahoney accepted that Freud obtained a degree of success in restoring his patient to functional life, though he considered Freud exaggerated the extent of this in his casestudy.[26] Others have suggested that by concentrating on building rapport with his patient, at the expense of analyzing the negative transference, Freud merely achieved a temporary transference cure.[27] Lacan for his part concluded that although he did not "regard the Rat

Man as a case that Freud cured", in it "Freud made the fundamental discoveries, which we are still living off, concerning the dynamics and structure of obsessional neurosis".[28] In a letter Freud himself wrote to Jung, shortly after publication of the case study, he claimed of the Rat Man that "he is facing life with courage and ability. The one point that still gives him trouble (father-complex and transference) has shown up clearly in my conversations with this intelligent and grateful man"[29] - a not insignificant reservation. But while Freud in the case-history had certainly claimed that "the patient's rat delirium had disappeared",[30] he had also pointed out the limited time and depth of the analysis: "The patient recovered, and his ordinary life began to assert its claims...which were incompatible with a continuation of the treatment".[31] As the average length of time expected of an analysis increased from months to years over the 20thC,[32] so too the success of the Rat Man's case has perhaps come to resemble rather the symptomatic relief of brief psychotherapy or focal psychotherapy, more than the achievement of a full psychoanalysis.[33]