IV. Problems of Hypertension

There was a tendency among the speakers at the Round Table to demand a critical re-examination of the prevailing scientific theories as to the relations between emotion and the so-called psychosomatic disorders. According to them, "getting your blood pressure up" and hypertension as a disease process may be two entirely different things. The disease process, hypertension, ought not be confused with one of its clinical signs, namely, elevated blood pressure. The phenomenon of vasomotor instability should perhaps be distinguished from the disease itself. Challenging favored hypotheses even further, some of the participants in the Round Table wondered whether rage, repressed or otherwise, had any specific relation whatever to hypertension. Questions were raised at to whether Cannon's concepts of emotion and bodily change, the "fight or flight" theory, were being misconstrued. Finally, it was asserted that while increased peripheral resistance in the arterioles was basic to hypertensive disease, the pathophysiology of this condition was not yet clear, and hence it is not possible to attempt a correlation with specific psychic states.

In an introductory statement, Maurice Levine stressed the need to bring psychoanalysis into closer relation with medical research and treatment. He expressed the hope that an alert group could expose gaps in our knowledge and stimulate the formulation of critical research designs. The relative newness of this type of panel at a psychoanalytic meeting provides some special interest. What is the potential of psychoanalysis for a significant contribution to the whole problem of somatization of anxiety?

As against an anticipated offering of perhaps six short papers, there were in all ten separate contributions. I shall endeavor to give each a place in this report. Since the subject matter of these contributions is so vast in scope, I shall take the liberty of making selective references to these papers in accordance with their pertinen