The Analysis of a Transitory Conversion Symptom Simulating Pertussis

The transitory conversion symptom which I wish to describe is one of an acute attack of sinusitis with respiratory symptoms simulating pertussis. The attack occurred in the fourth month of analysis of a twenty-five year old male patient, a post-graduate student working for a master's degree, who came to analysis because of sleep walking, severe night terrors and psychic impotence. In his sleep walking episodes he invariably walked toward a window or another bed and then returned to his own. The character of the impotence was such that it appeared to constitute a prolonged adolescence.

He was the only child. His parents had separated when he was five. His father died when he was ten and during the interval from five to ten he lived with his mother and his grandparents. He was particularly fond of his father and also his grandfather whose death followed a few years after that of his own father. From that time until he entered college two years ago he lived with his mother and grandmother.

When he came to the analysis, he complained of a double antrum infection which, however, was not severe but had been present for about two years. He had had similar difficulties as a child, but was uncertain of the exact dates of the disturbances. The antrum infection became progressively worse during the analysis up to the time I am about to describe, when he developed a severe cough which he believed was due to the drainage of mucus from the antrum into the posterior pharynx. Just previous to this attack it seemed necessary to his analysis for me to discourage his wish to accompany his mother to Alaska for the summer. I suggested that he continue in analysis until my vacation period and then either take his vacation alone or possibly accompany me on mine, continuing his analysis during that time. He reacted to this with intense hostility. He particularly emphasized his inability to entertain himself, the great disappointment it would cause his mother and his difficulty i