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Psychoanalytic Case Study of Hannibal Lecter:

A Case Conceptualization and Treatment Plan

Chad J. Ressler

Liberty University

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Abstract

Freudian psychoanalysis is the pillar and foundation of psychotherapy. Throughout the years, it

has undergone several developments and evolved into different school. However, Freud’s

contribution of the topographic model of the human mind has been invaluable. This model

allows one to better understand client’s struggles and sources of anxiety, and the techniques

advocated by Freud are useful for anyone trained in psychotherapy. Freud also provided for a

significant understanding of early childhood events and their relationship to subsequent

pathology (Corey, 1996). This paper will examine a fictional client, Hannibal Lecter. A case

conceptualization and treatment plan will be developed based on classical Freudian

psychoanalysis. Hannibal suffers from post-traumatic stress that led to a super-ego that

incorporated values we would consider evil, preventing him from experiencing moral anxiety.

Hannibal utilized an intricate web of defense mechanisms to protect himself as a child that will

need to be worked through. While Hannibal’s prognosis is not favorable, the possibility of a

psychoanalytic approach combined with Christian principles could provide the necessary

ingredients for healing.

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Psychoanalytic Case Study of Hannibal Lecter:

A Case Conceptualization and Treatment Plan

In terms of psychoanalytic theory, Freud believed that conflicts during a child’s early

development were the root of all psychopathology (Murdock, 2009). Human beings are largely

unaware of these conflicts, and as one progresses through the various psychosexual stages an

unhealthy resolution produces long lasting effects. For Freud, the most important stage of

development was the phallic stage, where the child seeks to resolve the oedipal complex.

Central to Hannibal’s case is he did resolve this complex, was forced to engage in numerous

defense mechanisms to deal with post-traumatic stress, and developed a weak super-ego. Thus,

the goal of treatment will be to assist Hannibal’s ego to “achieve progressive conquest of the id”

(Freud, 1960, p. 58).

Presenting Concerns

Hannibal presents with post-traumatic stress disorder as a result of the killing of his

family and witnessing his sister being murdered and cannibalized. Hannibal reports having

flashbacks of this memory, yet indicates that it creates little anxiety in him. Though Hannibal

seems to have loved his sister, Mischa, very much, he remains detached from these feelings due

to the anxiety it would cause him were they allowed entering his conscious. The flashbacks are

generally of her which led to the conclusion that Hannibal did, in fact, experience love for his

sister at one time. Hannibal does not speak much of his parents apart from the fact that his

upbringing was quite normal, smugly remarking that he “had resolved every stage quite

adequately”. His family lived on a very nice estate with his father holding the title of “Count”

which seemed to elicit some pride in Hannibal (Gregory, 2002).

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During the interview we discussed his crimes and Hannibal was amused at being labeled

a psychopath. He appeared to take a certain pride in the moniker and indicated that, while he

was considered a psychopath, he at least carried out his deeds with a certain refinement and

elegance. Hannibal experienced no remorse for the killings, and opined that the killing of one of

his victims improved the sound of the Baltimore Symphony (Gregory, 2002). Hannibal also

showed no emotion when discussing the cannibalization of his victims.

Case Conceptualization

Intrapsychic conflict is at the core of Freud’s psychoanalysis, and one’s behavior is a

result from the war occurring between the three main structures of the mind: id, ego, and

superego (Murdock, 2009). Freud began by outline three different levels of the mind:

unconscious, preconscious, and conscious. The unconscious motivates most of one’s thoughts

and actions, and constitutes the largest part of one’s mind. The preconscious contains that which

is not yet conscious, but could become conscious either “quite readily or with some difficulty”

(Feist and Feist, 2009). The conscious has the most limited role and contains all those things in

one’s awareness.

The id, ego, and superego reside in different parts of one’s mind and often overlap the

different levels with the exception of the id which remains wholly unconscious. The id is the

most primitive area which operates on the pleasure principle, seeking to reduce tensions by

satisfying needs (Feist and Feist, 2009). The id, being unconscious, is inaccessible to the mind

and is characterized by its illogic and pleasure seeking nature. The ego develops out of the id

and operates on the reality principle and has contact with the external world. The ego must find

a way to satisfy the demands of the id while simultaneously protecting the individual (Murdock,

2009). However, the third entity, the superego, also makes demands on the ego. The superego is

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partly conscious and partly unconscious and is equated with one’s conscience. The superego

incorporates its values from parents and other authority figures during the phallic stage upon

resolution of the oedipal complex. Thus, the ego is forced to balance the demands of the id and

the superego (Murdock, 2009).

Children progress through a series of psychosexual stages in which a primary conflict

must be resolved through proper amounts of satisfaction. These stages are the oral, anal, phallic,

latency, and genital. The phallic stage holds great importance because it is in this stage that the

boy must resolve the oedipal complex. Freud (1949) writes, “The third phase is that known as

the phallic one, which is, as it were, a forerunner of the final form taken by sexual life and

already much resembles it” (p.25). The young boy, having developed sexual desires for his

mother fears castration by his father when this is discovered. This castration anxiety is resolved

by the young boy repressing his desires for his mother and incorporating the values of his father.

Here is the beginning of superego development (Murdock, 2009).

Hannibal’s parents suffered a violent death followed by Hannibal witnessing the

cannibalization of his sister. These traumatic events sparked a chain event rupturing Hannibal’s

psyche, leading to his use of numerous defense mechanisms, and ultimately becoming a killer

and cannibal. To properly treat Hannibal, it is incumbent to understand the logical order of what

occurred in his life.

Hannibal’s first loss was that of his parents at age 5. This resulted in Hannibal being

unable to resolve his oedipal complex during the phallic stage of development as described

above. The consequence of this was that it created a “superego lacunae”, a gap in Hannibal’s

superego development (Maddux and Winstead, 2012, p. 284). Hannibal was unable to

incorporate the values of parental figures into the formation of his superego, thus arresting its

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development. Following the death of his parents, Hannibal reported being captured by army

deserters where he and his sister were held as food for the soldiers. While Hannibal was not

found to be a suitable meal, his sister was (Gregory, 2002). Hannibal witnessed his sister being

murdered and cannibalized which began a chain event that would forever alter Hannibal’s

psyche. Repression, one of Freud’s most basic defense mechanisms that allow an individual to

prevent unacceptable material from entering the conscious, was only partially successful for

Hannibal as evidenced by the fact that he still has flashbacks of this memory (Murdock, 2009).

Having a weakened ego, Hannibal then engaged in regression, returning to an earlier, safer stage

of development. Hannibal retreated back into the oral stage; however, his cannibalization

indicates that he became fixated at the oral-sadistic stage. This is characterized by the

emergence of the teeth in an infant where they then begin biting as an anxiety defense (Feist and

Feist, 2009).

As was mentioned above, Hannibal was unable to successfully resolve his phallic stage

and oedipal complex which is necessary for proper superego development. For Hannibal, the

last defense mechanism his ego utilized created the psychopath he became. Hannibal filled the

gap in his superego by introjecting the values of his captors instead. Feist and Feist (2009) write,

“during the Oedipal period, the young child introjects the authority and values of one or both

parents – an introjection that sets into motion the beginning of the superego” (p. 37). While

Hannibal had begun this stage and the development of the superego, with the death of his

parents, the lacunae was filled with the values of his captor’s in the ego’s attempt at protecting

Lecter’s psyche. Hannibal had no qualms about discussing his cannibalization of his victims,

even describing what parts he served and how he would cook them. Being fixated in the oral-

sadistic phase was the result of incorporating his captor’s values while simultaneously regressing

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into a safer period. The temporal order of his defense mechanisms appears to be that he first

engaged in repression, and then he simultaneously engaged in introjection and regression.

Unfortunately, his super-ego absorbed the values of his captor’s which fixated him in an oral-

sadistic stage.

The traumatic stress that Hannibal experienced along with introjecting his captor’s values

led to him becoming a psychopath. A study by Thierry Pham (2012) noted that psychopaths

more often report a traumatic event than non-psychopaths. Hannibal, a psychopath, kills without

remorse because he does not experience moral anxiety due to the traumatic event. Moral anxiety

results from ego-superego conflict, and the fear of punishment from the superego (Murdock,

2009). Hannibal introjected the values of his captor’s and so the weak superego he possesses

allows for the killing and cannibalization; Hannibal’s ego is not threatened by punishment when

his id compels him to kill. Hannibal’s reports of flashbacks indicate that this experience forces

him to relive the trauma providing Hannibal with the impetus to kill.

Treatment Plan

Goals for Counseling

As Gerald Corey (1996) writes, “two goals of psychotherapy are to make the unconscious

conscious and to strengthen the ego so the behavior is based more on reality and less on

instinctual cravings” (p. 111). For Hannibal, one goal will be to make him aware of the defense

mechanisms he uses, most specifically the repression of the traumatic childhood event, so that he

can experience and deal with the anxiety consciously. The second goal will be to reconstruct the

values of his superego in order for Hannibal to experience moral anxiety, thus strengthening his

ego as well. In order to accomplish these goals, the traumatic childhood event will need to be

“reconstructed, discussed, interpreted, and analyzed” (Corey, 1996, p. 112). Second, a focus on

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transference will be necessary to reconstruct the superego. As Murdock (2009) points out, “much

of the transference is rooted in the Oedipal complex” (p.51).

Interventions

Analysis of transference. Transference is defined as “the client’s unconscious shifting to

the analyst of feelings and fantasies that are reactions to significant others in the clients past”

(Corey, 1996, p. 113). This intervention will be necessary for Hannibal because in the course of

transference clients will often regress back to a childhood conflict emotionally and then attach

them to the therapist (Corey, 1996). It will be necessary to work through this transference once

Hannibal reaches that stage. It is hoped that Hannibal would transfer the feelings about his

captors onto the therapist where they could then be worked through, interpreted, and finally

demonstrating to Hannibal that his feelings are rooted in the past (Murdock, 2009). With these

feelings resolved, it is hoped that Hannibal’s ego will grow in strength as well by not having to

expend as much psychic energy.

Interpretation. Interpretation can take on many forms such as teaching, explaining, and

dream interpretation, and includes “identifying, clarifying, and translating the client’s material”

(Corey, 1996, p. 118). Interpretation of Hannibal’s use of projection will be necessary in order

to provide a concrete example of his malformed superego. Lecter not only cannibalizes

physically, but also psychologically. Lecter chose to be a psychiatrist in order to continue to

harm individuals, disturb them, and control them as he himself was controlled (Gregory, 2002).

The logic behind this technique would be to demonstrate to Lecter how these actions are the

result of his past trauma that prompts his id to seek to harm others without the aid of the

superego to create the moral anxiety necessary to avoid this behavior.

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Dream Analysis. Dream analysis aids the therapist in uncovering painful unconscious

material that the client is unaware of. Freud saw dreams as “symbolic wish fulfillments”

(Murdock, 2009, p. 54). As Hannibal reports the manifest content of the dream, that material

that is consciously reported, the analyst will interpret the dream and pull out the latent content, or

the content that has been disguised (Murdock, 2009). While Hannibal has not yet reported any

dream content, he has discussed flashbacks and one can logically deduce that his dreams are also

of a similar nature. Moreover, as Owen Renick (2006) notes, “disturbing dreams are often a

prominent feature of post-traumatic stress disorders, and an individual’s post-traumatic dreams

can offer useful clues to the best clinical approach…” (p. 118). Hannibal’s dreams, properly

analyzed, will provide necessary markers on the roadmap to his health.

Spiritual Application

As a Christian counselor, a spiritual approach is of utmost importance to Hannibal’s

treatment. Without the assistance of the Holy Spirit, Hannibal has no hope of recovery. The

problem arises in the compatibility of Freudian psychoanalysis with a Christian worldview.

Psychoanalysis originated from an atheistic epistemology assuming that everything has a

biological cause as well as being overly deterministic (Jones and Butman, 2011). A second area

in which this theory is incompatible with a Christian worldview is the focus on “individualism

over and against interdependence (Jones and Butman, 2011, p. 122). As believers, we

understand that we are completely dependent on God not only for our existence, but for our daily

needs. A third area of incompatibility is the focus on psychosexual development as the root of

pathology (Jones and Butman, 2011). Scripture is clear that the root of our problem is sin, not

the improper resolution of a psychosexual stage.

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However, there are areas where psychoanalysis and the Christian worldview meet. While

psychoanalysis stems largely from Freud who was an atheist, one commits the genetic fallacy by

dismissing everything. From a Reformed perspective, we are all born dead in trespass and sin

and that God is sovereign in our lives. We are slaves to our sin nature, and, thus, much of our

behavior is determined as we can only choose between different sin options. The only hope for

freedom is to be regenerated by the Holy Spirit which then frees us from slavery enabling us to

choose the good. The use of defense mechanisms certainly aligns with Scripture and, as Jones

and Butman (2011) note, “the Scriptures speak directly to our tendencies to be deceitful to self

and others and to avoid facing painful realities (cf. Jer. 17:9)” (p. 121). One final area where they

meet is that while we our slaves to our sin there is not much one can do in their own power to

reduce anxiety, however, once freed, with the aid of Christ one can then begin to make different

choices in order to reduce anxiety. Jones and Butman (2011) note that psychoanalysis does

provide a good theoretical construct for “more adaptive and goal-oriented means of managing

anxiety” (p. 121). Combining psychoanalysis with a regenerated believer capable of choosing

good can be an effective model for therapy.

Hannibal was open to Christian counseling particularly because he had never encountered

this in any facility he had been held in. As a result, he was curious as to how someone like

myself, educated in psychology, could possibly hold such an outdated belief. While my first

instincts were to engage Hannibal’s intellect through the use of apologetics, I decided that it

would be more helpful to simply model the love of God through an empathic therapeutic

relationship. As transference occurred, it is hoped, that Hannibal’s superego would introject

God’s law in some form. Even as an unbeliever, Paul tells us in Romans 1 that all people

suppress the truth in unrighteousness.

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Conclusion

Hannibal’s prognosis is poor. While the techniques and interventions described above

can be effective, Hannibal’s pathology is very severe. Treatment would most likely be quite

lengthy; weekly sessions for up to 5 years (Corey, 1996). Transference and the building of the

therapeutic relationship will be severely hampered by Hannibal’s initial inability to feel remorse

as he attempts to utilize projection in order to “cannibalize the therapist’s mind”. Hannibal will

need to relive the trauma of that day and experience the anxiety associated with it in a safe and

healthy environment. Only then will he be able to begin the process of reconstructing his

damaged psyche. Through a Christian psychoanalytic approach, it is hoped that Hannibal would

be able to experience the unconditional love he so desperately seeks, yet is too scared to

experience.

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