"Rat Man" was the nickname given by Sigmund Freud to a patient whose 'case history' was published as Bemerkungen über einen Fall von Zwangsneurose ['Notes Upon A Case Of Obsessional Neurosis'] (1909). The nickname derives from the fact that one of the patient's symptoms was an obsessive fantasy concerning two people close to him, in which a pot of rats was fastened to their buttocks to gnaw into the anus.
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 Ernst Lanzer  (1878–1914) -- though many other sources maintain that the man's name was Paul Lorenz  .
'Notes Upon A Case Of Obsessional Neurosis'
The case study was published in 1909 in German. Freud saw the Rat-man patient for sixth months, despite later claiming the treatment lasted a year. He considered the treatment a success.
The patient presented with obsessional thoughts and with behaviors that he felt compelled to carry out. The case received its name from a torture he had heard about from a military officer, where rats would eat their way into the anus of the victim. The patient then felt a compulsion to imagine that this fate was befalling two people dear to him, specifically his father and his fiancée. The irrational nature of this obsession is revealed by the fact that the man had the greatest regard for his fiancée and that his revered father had actually been dead for some years. 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.
The Rat-man also often defended himself against his own thoughts. He would have a secret thought that he wished his father would die so he could inherit all of his money, and then he would shame 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 so that Freud would have more money.
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 verbal associations and symbolic meanings.
Freud believed that they began with sexual experiences of infancy, in particular harsh punishment for childhood masturbation, and the vicissitudes of sexual curiosity. In the case study, Freud elaborates on his terms rationalization, doubt and displacement.
In a footnote, Freud laments that long term follow-up of this case was not possible, because the patient was killed in World War I.
Criticism of Freud's interpretation
The only known case in which Freud's notes survive is that of Ernst Lanzer, the Rat-Man. Freud treated him for obsessions, particularly the dread that something terrible would happen to his father and his fiancée. His fear of rats, Freud showed through elaborate interpretations, was based on disguised homosexual fantasies. 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.
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