The patient was a 37-year-old white woman who worked as a secretary. She entered psychotherapy in 1952 after developing "rather diffuse phobias, somatic symptoms, and anxiety" after a car accident during which her sister sustained minor injuries. Eight years later, a new things started getting weird.
In 1960, a new symptom developed, the buying and hoarding of large quantities of raw hamburger. The precipitating event again involved the sister, and the onset of the symptom was quite interesting. The week before the sister was to depart on an airplane trip, the patient bought a cooked hot dog, removed it from the bun, and carried it around in her handbag. This was repeated once when the hot dog spoiled, and after this the patient switched to raw hamburger. When asked later she said the hot dog wasn't quite right, the hamburger somehow seemed better.
The therapists note that they "initially reacted to the hot dog symptom with our own fantasy, that it represented a penis, but this missed the mark as badly as the anxiety-hysteria diagnosis of earlier therapists."
The hamburger hoarding narrative continues, but first consider that during the time described, the patient was able to "attend graduate school, obtaining straight As, and to have pleasurable heterosexual relationship which included moderate intimacy."
Once it began, the buying and saving of hamburger was inexorable. For about two years, it remained at two to five pounds a day, and then steadily increased to huge quantities. This increase mainly had to do with the patient's extreme, if not total, inability to manage ambivalence. As the transference began to change from that of ineffectual, passive "talker," her buying of hamburger increased to massive proportions, by her estimate, 60 pounds a day."
The patient would take that hamburger and stuff it into the back of her large, black, hearse-like automobile, which happened to be a replica of her father's. "As she had trouble parting with hamburger, even when it became rotten, it soon became clear that she had converted her father's automobile into a hearse in which she carried his rotting body and to which she gave renewed life in the form of fresh hamburger," they concluded.
When the habit got to the 60 pounds a day, the patient was told that she had to enter a mental hospital. The psychiatrists spin all kinds of stories about why hamburger had assumed such monumental importance in her life. Several episodes in the patients life had "further reinforced" a link between "blood, eating, and mother." But it's unclear that they really knew what they were talking about, at least by modern psychological standards. Take this passage, which follows a discussion of her relatively normal life outside the hamburger stuff.
These behavioral indications of genital psychosexual development were supported by fantasies that contained an oral-sadistic and genital components. For example, in one session late in treatment she associated to hamburger as being meat pushed through a screen, and then from the screen to sand and a summer house in the country, where there were many snakes. Her father used to drive her there in the car, and on the way she reported often seeing squashed snakes.
The psychiatrists also saw in her behavior a cannibalistic urge, though she never expressed the desire to eat the hamburger itself. That's because she told them that one time she had a vision at a market:
After nearly three years of treatment, the patient hesitatingly mentioned a fantasy she had while looking at a supermarket display of hamburger. She felt a sudden impulse to bury her face into this display full of meat and devour it.
They read this memory, along with some other descriptions, as indicative of an "underlying fantasy" that she was "a dangerous, murderous person, a kind of vampire (or Whitico) who killed and devoured people in their sleep."
