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Moore, B.E. (1960). Congenital Versus Environmental: An Unconscious Meaning. J. Amer. Psychoanal. Assn., 8:312-316.

(1960). Journal of the American Psychoanalytic Association, 8:312-316

Congenital Versus Environmental: An Unconscious Meaning

Burness E. Moore, M.D.

It is a common observation in psychiatric practice that patients will insist that their problems are a congenital affliction for which there is no real hope of cure. Perhaps closely allied is the stubborn belief among some doctors, even including psychiatrists, that all psychiatric disorders must have an organic basis. The content of an analytic session revealed one unconscious meaning as the basis for such a belief. It represents a complex intellectualized defense which may be expressed briefly thus: "I am not to blame for my incestuous masturbation fantasies and acts. They are not my fault, but mother's, since I was born with a penis which causes me to behave this way. Therefore, I do not need to fear losing my penis, but may continue to enjoy myself." Although it is hazardous to generalize, it may be that the unconscious basis for the belief in this case may apply to other instances as well.

A middle-aged man sought treatment because he had fallen in love with a prostitute (2). Despite his conscious intentions, he had been unable to free himself of his attachment during two years of analysis. On several occasions he expressed the wish that he might be hypnotized and directed to return to his wife. One day he mentioned having seen a television program about a marital reconciliation court in which the marital partners were bound by contract to reconcile their differences and could be held in contempt of court for a breach of contract. He expressed the wish that he could be bound by such a contract to be faithful to his wife.

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