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Glauber, I.P. (1949). Observations on a Primary Form of Anhedonia. Psychoanal Q., 18:67-78.

(1949). Psychoanalytic Quarterly, 18:67-78

Observations on a Primary Form of Anhedonia

I. Peter Glauber, M.D.

A specific form of anhedonia appears clinically as a chronic state of lack of conscious pleasure—distinct from psychological states having a quality of painfulness—often punctuated by acute anxiety, unconsciously utilized to re-establish the chronic state whenever its maintenance is threatened by pleasure or by depression. Nosologically, the patients in whom this state has been observed were all schizoid personalities. Their symptomatology prominently included stuttering, homosexual perversions, gastrointestinal disorders (peptic ulcer, intestinal spasm, jaundice, diarrhea) and migraine. These symptoms are not considered pathognomonic. Dynamically, this state of inhibited fulfilment stems from those manifestations of orality that derive from narcissistic fixations of libido and its two main forms of expression—identification and projection—in contradistinction to oral regression from object libido. Objectively, the manifestations of this emotional state are described by many terms: withdrawal, detachment, isolation, alienation, chronic aloofness, listlessness, emotional block, etc. A term adequately descriptive of the subjective state is lacking.

Anhedonia (an = not, hedone = pleasure) an absence of pleasure, was first used by the French psychologist Theophile Ribot (1) in contradistinction to analgesia, or absence of pain. As Ribot defined it, it is 'an insensibility relating to pleasure alone'. It seemed to us an apt term to adopt because of the negative quality in our patients' descriptions of their subjective states. The qualification 'primary' was added to delimit the type of patients: schizoid characters in whom, because of very early fixations, there resulted a sense of distance and a lack of pleasure in all of their relationships. It may be a chronic

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Read before the Joint Session of the American Psychoanalytic Association and the Section on Psychoanalysis of the American Psychiatric Association at New York on May 19, 1947.

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