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(1962). International Journal of Psychoanalysis. XLI, 1960: Symposium on Disturbances of the Digestive Tract. Angel Garma; Melitta Sperling; Samuel Z. Orgel; Willy Højer-Pedersen; Bela Mittelmann. Pp. 444-466.. Psychoanal Q., 31:120-121.
Psychoanalytic Electronic Publishing: International Journal of Psychoanalysis. XLI, 1960: Symposium on Disturbances of the Digestive Tract. Angel Garma; Melitta Sperling; Samuel Z. Orgel; Willy Højer-Pedersen; Bela Mittelmann. Pp. 444-466.

(1962). Psychoanalytic Quarterly, 31:120-121

International Journal of Psychoanalysis. XLI, 1960: Symposium on Disturbances of the Digestive Tract. Angel Garma; Melitta Sperling; Samuel Z. Orgel; Willy Højer-Pedersen; Bela Mittelmann. Pp. 444-466.

Garma believes that patients suffering from peptic ulcer form transference relationships with love objects destined to frustrate them genitally, thereby causing a regression to oral-digestive fixations. In the unconscious there is reactivation of a destructive mother image who sucks, bites, and digests these patients from within and forces them into harmful modes of eating. This leads to somatic processes which terminate in peptic ulcers. The author stresses the psychogenic elements in ulcers, wherein the symbol and its accompanying affect autoplastically alter the soma. This is similar to the dynamics of the pregenital conversion symptom in hysteria. The effects of any therapy directed toward the alleviation of the somatic aspects of the illness are minimized.

Sperling deals with the rich unconscious fantasy life of a patient suffering from ulcerative colitis, and relates these fantasies to the specific somatic symptoms of the disease. She feels that ulcerative colitis is an organ neurosis with pregenital conversion symptoms. In the case cited the colon assumed the role of a sexual organ without manifest fears or inhibitions of the genital act itself. The fears and fantasies were of a pregenital nature and were acted out in the bouts of ulcerative colitis. Treatment transferred these conflicts to the genital area, from whence they were ultimately resolved. Sperling minimizes the importance of congenital factors in the predisposition of idiopathic ulcerative colitis. She considers the somatic symptoms pregenital conversions based on unconscious fantasies and conflicts in a person predisposed to such a reaction by a specific mother-child relationship in early life.

From material gathered from analyses of twelve patients with peptic ulcer, Orgel concludes that long-standing neuroses were present in all the cases. The ulcer appeared as a symptom when environmental stresses intensified infantile conflicts. Oral-receptive and oral-demanding attitudes dominated the personalities of these patients. The character neurotics had a strong oral fixation; in the obsessional neurotic and mixed psychoneurotic, regression was more important and represented a retreat from an unresolved Oedipal conflict. Inability to release their aggression outward caused these patients to discharge the conflict in the form of somatic and emotional suffering.

According to Mittelmann there is no specific structure or dynamics to be found in the peptic ulcer patient or, for that matter, in any psychosomatic disease. A significant number of patients may fit a specific picture but some do not. The reason for this seems to be found in a somatic constitutional predisposition to psychosomatic illness of the organ system involved. It is not clear whether

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this constitutional factor is congenital or due to very early psychological traumatic experiences.

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Article Citation

(1962). International Journal of Psychoanalysis. XLI, 1960. Psychoanal. Q., 31:120-121

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