ng into the skin of the wrist, only with the difference
that it seldom was found in both arms, usually in the one or the
other. The sensation became a strictly tactual one with optical
overtone, but there was no emotion in it. The pain element had
disappeared. Also the shock, which still recurred in the first days
slowly disappeared. The longer the symptom lasted, the more the
optical factor faded away, and the tactual factor came into the
foreground after three or four weeks. Perhaps seeing a razor in a
store window or a pocket knife open no longer stirred up the image
of cutting the wrist, but simply a strong tactual sensation, as if
the skin of the wrist was scratched and pinched. Finally, after
about two months, the association character disappeared to a high
degree and the scratching and cutting sensation in the skin became
independent and automatic. The patient awoke in the morning with a
vivid tactual hallucination of being cut without associating with
it any picture of a knife. Throughout the day, in the midst of work
and in the midst of conversation, sometimes one and sometimes the
other wrist became the center of the exasperating sensation, easily
bringing with it involuntary reactions as if to withdraw the arm.
This became more and more frequent and more and more vivid.

The doctor, fully aware of the borderland character of this
experience, felt sure that his inner fight against the disturbance
would get control of it. The usual tonics did not show any
influence. On the other hand, there were no other nervous symptoms
and, with his most acute analysis, he did not find the slightest
trace of emotion any longer. When the symptoms reached a point at
which they seriously interfered with his comfort, he asked me for
psychotherapeutic treatment, under the condition that I was not to
apply hypnotism. He was absolutely averse to the use of hypnotism
in his own case because he was afraid that to be hypnotized would
mean for him a certain disposition to fall into hypnotic sleep by
auto-suggestion, as he knew the vividness of his imaginative
sensations. He wanted to avoid that the more as his own
professional work might sometimes demand hypnotizing in his own
practice. In any case he had an aversion to it and asked for other
means.

Under th