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Fromm-Reichmann, F. (1937). Contribution to the Psychogenesis of Migraine. Psychoanal. Rev., 24A(1):26-33.

(1937). Psychoanalytic Review, 24A(1):26-33

Contribution to the Psychogenesis of Migraine

Frieda Fromm-Reichmann, M.D.

Experience with eight cases of migraine (two men and six women) has given me the impression that they all were patients suffering from unresolved ambivalence; they could not stand to be aware of their hostility against beloved persons; therefore they unconsciously tried to keep this hostility repressed, and finally expressed it by the physical symptoms of migraine.

I had the good fortune to have this brought home to me by one of my patients who used to develop and to stop migraine attacks in the course of her analytical hour. She expressed her original ambivalence which she recognized later to be the reason for her migraine attacks most appropriately: “When I was a child,” she said, “I did not always totally agree with my beloved mother's ideas and resented the one or other decision she made, Each time I felt very badly and guilty of treason, and finally I got this bad headache.” During her analysis the patient went through a similar experience in the transference, feeling she betrayed the analyst whenever she felt any criticism about analysis or analyst. Consequently she repressed for a long time all antagonism toward the analyst. As a result she would often develop a migraine attack during her analytical hour. On becoming conscious of her hostility to the analyst her migraine symptoms would immediately, to quote her own words, “melt away.”

In order to understand why the organism should choose as it were the symptoms of migraine as a means of expressing repressed hostility we may remind ourselves what its classical and occasional symptoms are: They are as we know: above all the attacks of onesided headache, and variably scintillating scotomata or other visual disturbances, nausea, retching and vomiting, intestinal disturbances, namely spastic constipation and final diarrhea, urine-retention and attacks of general, sometimes one-sided chilliness and paleness.

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