1. The reason of why the patient was being seen Little Hans had a phobia of horses (As Psychology, 2005) which made life difficult in Victorian times, as horses and carriages were the norm for transport. Initial reports about Hans came directly from his family, mostly his father, who reported that at age 3 Hans had cultivated a deep interest in his "widdler" (his penis). Further, this interest by Hans had extended to the "widdlers" that other people were assumed to have. On one occasion he even asked his mother, "…do you have a widdler too?" At this time his dreams and fantasies seemed to have widdlers and widdling as dominant themes (As Psychology, 2005).
At age 3 and a /2 years, Hans was told by his mother not to touch his widdler or she would call the doctor to come around to cut it off. At this time, his mother also birthed his sister Hanna. Further, his mother sometimes threatened to leave the family for good. It appears that Hans was incredibly jealous of his sibling at first. Although his feelings of jealousy appeared to wane after a few months. Hans had also developed a significant interest in other children, especially girls it seems. He began to form emotional attachments to them (As Psychology, 2005).
At around age 5, Han's father was concerned enough to contact Freud. The description the father gave of Hans was that the dominant problem was, “He is afraid a horse will bite him in the street, and this fear seems somehow connected with his having been frightened by a large penis’. In his letter to Freud the father detailed conversations he had had with Hans (As Psychology, 2005).
2. A summary of the work with patient
Freud used a case study method to evaluate Little Han's phobia. However, the initial study observations were carried out by Han's father. As the record of work Freud undertook with Little Hans is retrospective, it is not clear if Freud ever actually met with Hans more than once. Freud corresponded with the father to gain information about the case and to provide instruction as to how to proceed. Throughout the case Freud leveraged the special relationship that Hans had with his father, as this provided a medium for detailed disclosures and discussions about thoughts and behaviors intimate to the child (As Psychology, 2005). A Clinical Introduction to Freud (Fink, 2017) details techniques Freud used for anxiety ridden clients such as Little Hans.
3. The dynamics of the problem Freud inquired of Hans his phobia of horses, which Hans referred to as "nonsense". Hans
pointed out that he did not like horses that had "black bits around their mouth". From this Freud concluded that the horse symbolised Han's father and the black bits on a horses' mouth corresponded to his father's moustache. Following the interview, the father made a record of a conversation he had with his son where Hans said, “Daddy don’t trot away from me!” (As Psychology, 2005).
Also, it appears that he became quite frightened about horses falling over too, as he once described to his father a day when he had seen this happen (his mother confirmed the sighting). Although his parents kept detailed records of conversations they had with Hans about his phobia, they asked many leading questions that may have biased the results. As such, Hans may have wanted to please his parents with his responses. For example: Father: When the horse fell down did you think of your daddy?
Hans: Perhaps. Yes. It’s possible.
4. The paradigm that was used and how I felt the case was resolved
Freud developed the theory of the Oedipus complex, which was a critical concept in psychoanalysis. Freud used Oedipal theory to explain the behaviors, cognitions and psyche of Hans. To Freud, children had 5 stages of psychosexual development to pass through, as the basic human drive was believed to be sexuality. The stages were comprised of the: oral, anal, phallic, latency and genital (As Psychology, 2005).
Stages 1-3 took place within the child before they turned five. During the ages of 3-5, which was the age of Hans, the phallic stage was unfolding, and sexual identification takes place. Freud hypothesised that Hans, like all other young boys at this stage, was experiencing the Oedipus complex. And Hans was experiencing dramatic conflicts that could only be resolved by his identifying with his father, because his father was of the same sex as himself. As such, Hans was had developed a strong need to ‘possess’ his mother’s affections, leading him to see his father as a rival and wanting him to be gone so that he, Hans, could have his mother all to himself (As Psychology, 2005).
However, according to Oedipal theory, Hans would at some point realize that his father was much more powerful and physically bigger than he was and would develop a fear that his father would recognize Hans as a rival, and attempt to castrate him. The continual threat of castration would make daily life difficult for Hans. Freud concluded that in order to cope with his anxiety, Hans had developed the defense mechanism ‘identification with the aggressor’. For this reason, Hans was quick to let his father know all the ways in which he, Hans, was similar to his father. For example, adopting similar values and behavioral repertoires. In turn, when his father saw Hans as a similar being, it would be less likely that his father would be hostile toward him (As Psychology, 2005).
To resolve the anxiety conflict, Hans’ father spoke with him about the fears Freud suggested that he had about father: losing his mother’s love and castration. Freud and Hans’ father reported that after such discussions, Hans did indeed display behaviors and cognitions that implied he had resolved the conflict of this stage and was no longer anxious (As Psychology, 2005).
5. Was it a successful outcome or not?
To determine the success of Freud's indirect work with Hans, it is perhaps best to go forward in time to when Hans was older. This makes sense as Freud believed the first few years in a child's life lead to how their personality would develop across time, so evidence of success of intervention with Hans should be visible in Hans's later life. If Hans had adjusted adequately to his sexual identity conflict, and resolved the issue of his sexual identification, then his years beyond childhood should have been functional (As Psychology, 2005).
There is only one record of Hans in later life, when he was 19 years old, and he returned to visit Freud and to read through his case notes (As Psychology, 2005). Hans claimed at that time that he remembered nothing of the conversations he had had with his father about his fear of horses. However, as a young adult he no longer had a phobia of horses. And he felt that his teen years were healthy, functional and without significant internal conflict (As Psychology, 2005).
Based on this brief insight into Hans later life it appears that Freud’s interpretation was correct and that his intervention worked. However, we are not privy to other events occurring in the life of Hans, and the notes in the article used for this worksheet leave out many details, such as Hans’ mother being in therapy with Freud too, or the dynamics of Hans family unit. For example, his mother had threaten to “cut off his penis” when he was playing with it (As Psychology, 2005). Also, due to the lack of rigor in documentation and measurement of Hans anxiety by Freud, the resolution of his phobia remains open to interpretation.
6. An alternate paradigm
Bowlby (1969/1982), a psychoanalyst, would perhaps have argued that the phobia Hans experienced could be understood by way of Attachment Theory. Attachment is the emotional bond that grows between the child and caregiver (Bowlby, 1968/1982). Attachment processes facilitate a child in future relationship building. Often in Western societies the mother is the primary caregiver. Bowlby used concepts from ethnology to investigate and explain child-mother relationships. Especially, he focused on a critical period for bonding to occur, and initiated studies into mother-child separation.
The birth of his little sister, which took Hans’ mother away from him for periods of time, may have caused anxiety for the young boy. Also, given the Victorian society at the time, when relationships with children were not as open and flexible as nowadays, the boding Hans had with his mother may have been inadequate.
As Psychology (2005). Freud, Sigmund (1909): Analysis of a phobia of a five-year-old boy.
Retrieved November 6, 2007 from http://www.holah.karoo.net/freudstudy.htm
Bowlby, J. (1968/82). Attachment and Loss, Vol. 1: Attachment. New York: Basic Books.