I feel as though I should preface this piece with a “New readers start here” summary. I shan’t. This dog has had its’ day and it’s time for it to go back into its’ kennel. We are  left with my patient’s friend whom I suggested was suffering from conversion hysteria. I suspect that in some way he identified himself with the dog. My patient had already said that his friend could be violent at times .”He would never back down from a fight. It didn’t matter if he knew he was going to get a beating, he couldn’t back down. As if he was hard-wired for aggression and violence.”  I asked about  his friends attitude to women.

“He was an odd mixture. He both loved and hated women. He’d been in arrested several times for domestic violence but none of the women would ever press charges. He go home  and for a bit it was all flowers and chocolates.Then something would happen and the violence would erupt. We often saw his girlfriends walking about wearing dark glasses. After a bit we stopped asking  ‘why?'”

With this in mind I contacted the friend’s psychiatrist and wondered if abreaction might be worth a try.

Here is a very brief definition of abreaction:

“Abreaction is a concept introduced by Sigmund Freud in 1893 to denote the fact that pent-up emotions associated with a trauma can be discharged by talking about it. The release of affect occurred by bringing “a particular moment or problem into focus”… and as such formed the cornerstone of Freud’s early cathartic method of treating hysterical conversion symptoms.”

In simple terms, if one can help the patient talk about an event, it brings it into consciousness where it can be thought about and discussed, in the hope of resolving the conflict.

We used this with the friend. We asked him about the black dog. At first he just laid there and shook his head. Which was a kind of progress! Then he said “That black dog was my life. It was me. I loved it. I hated it. I needed it and I loathed it I always knew that one day one of us would kill the other.It had to be that way. I always hoped it would kill me. But that’s not the way it was meant to be,” With this he relapsed back into his “coma”. And has never since moved or spoken. My patient came for  about a year longer then left, happy in himself and settled his marriage.