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McLaughlin, J.T. (1961). Journal of the American Psychoanalytic Association. VII, 1959: Structural Determinants of Phobia: A Clinical Study. Martin Wangh. Pp. 675-695.. Psychoanal Q., 30:143.
    
Psychoanalytic Electronic Publishing: Journal of the American Psychoanalytic Association. VII, 1959: Structural Determinants of Phobia: A Clinical Study. Martin Wangh. Pp. 675-695.

(1961). Psychoanalytic Quarterly, 30:143

Journal of the American Psychoanalytic Association. VII, 1959: Structural Determinants of Phobia: A Clinical Study. Martin Wangh. Pp. 675-695.

James T. McLaughlin

The author explores and develops Alexander's thesis that the phobic defense involves an intersystemic conflict fostered by a failure of control in a severe and defective superego. His clinical material is derived from the case of a woman suffering from a variety of phobias. Wangh's approach is based on the assumption that the process of phobic symptom-formation can best be understood through tracing the genetic development of the structural constituents, the evolution of defenses, and the patterning of identifications. He designates as decisive the following factors: 1, the ego function of drive control was impaired as a result of failure to solve early ambivalent conflicts, ascribable to cessation of contacts with the mother and the unsuitability of the alternative objects available to the child; 2, a pattern of avoiding conflict by withdrawal found a model in the mother's behavior of separating herself from the child at the first hint of tension; 3, a facility for ready object displacement was fostered by the tenuous primary relationship and the easy availability of substitute objects; 4, identification with the chief mothering substitute, a nurse, was impeded by the nurse's depreciated status, her primitive disciplinary techniques, and the mother's demand for allegiance; 5, instinctualization of sphincter control, under the regressive pressure of the nurse's authoritarian, seductive toilet training, became reflected in weakened impulse control in general; 6, blurring of ego boundaries and susceptibility to separation anxiety were fostered by the habitual use of enemas and cathartics; 7, impaired superego development resulted from faulty object-models in general, and seduction experiences, on both pregenital and genital levels, at the hands of nurse and father in particular. An important factor in differentiating this patient from the patient who acts out (whose genetic patterning is similar) was a strong ego core of common sense and solid defenses against sadomasochistic strivings, attributable to identification with the more favorable aspects of the nurse's personality. The phobic device was the result of the interplay between the defects in drive control and this stable ego component.

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Article Citation

McLaughlin, J.T. (1961). Journal of the American Psychoanalytic Association. VII, 1959. Psychoanal. Q., 30:143

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