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Garma (1968). The Psychosomatic Shift Through Obesity, Migraine, Peptic Ulcer, and Myocardial Infarction in a Homosexual. Int. J. Psycho-Anal., 49:241-245.

(1968). International Journal of Psycho-Analysis, 49:241-245

The Psychosomatic Shift Through Obesity, Migraine, Peptic Ulcer, and Myocardial Infarction in a Homosexual

Ángel Garma


The changes in the psychosomatic pathology of a homosexual were determined by modifications in his regressive level of sexuality, which in turn depended on the patient's capacity to face his genital conflicts. In early infancy, gential renunciation accompanied by regression to the first phase of the oral-digestve instinctual organization, which can also be termed his alimentary submission to his parents, caused him to become obese. After the age of puberty, this patient also suffered frequently from migraine which was caused above all by his feelings of guilt regarding his homosexuality which he felt to be very destructive. As he grew more adult and progressed towards genital activity, which was of a homosexual nature, his level of regression also progressed and reached the second oral-digestive phase. In accordance with this, his conflicts with his genital objects caused him to eat badly and to cathect food with painful psychological contents, which brought on digestive disturbances and a gastric ulcer.

At a later period, when he became more independent of his parents and more adventurous in his genitality, his regression advanced from an oral-digestive to an anal-sadistic level. In accordance with this, in situations of conflict, he no longer ate food that was not good for him, but undertook instead exhausting, muscular activity, and finally suffered an infarction of the cardiac muscle. Both organic lesions, his ulcer and his infarction, hold the meaning of genital castration, which owing to his regression took place in organs which had acquired secondary genital significance.

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