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Tradition has perpetuated the myth that hysterical illnesses are the easiest to relieve. Although hysterical symptoms may be easily dispelled, an underlying hysterical character can be influenced only with the greatest difficulty. Under extreme stress the hysterical character reacts with oral regression, with depressive or schizophrenic symptomatology, or with some form of addiction. The resistance of the hysterical character to change, the immaturity and instability of the ego structure, and its close relation to psychoses, are best explained on the basis of deep seated oral fixations. A hysterical patient's analysis is reported in which the earliest basic fixations were in the nursing period.
The inability of hysterics to solve the Oedipus complex is the consequence of oral fixations. If this assumption is correct some of the material presented by patients in analysis will require revaluation. For example, the incestuous dream of the hysteric may conceal behind the symbolic wish to cohabit with the mother (or father) a deeper, pregenital wish to be loved and protected by her (or him) to the exclusion of the rest of the world. Many of the manifestations of the castration complex become more meaningful when they are understood, not in terms of genital anxiety, but in terms of fear of losing love or being cut off from the mother's breast. The pseudo-sexuality of the hysteric may be interpreted too exclusively along genital lines without considering its pregenital significance. The sexuality of the hysteric is false primarily because it expresses a pregenital oral receptive wish rather than a genital one. An orally fixated individual may be either neurotic or psychotic, depending upon the balance between ego strength and ego stress.