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The ear can serve as a substitute for both female genitalia and anus. The ear is more than a receptive opening; it is also a protuberance which can be valued as a symbol of strength. Clinical material is described illustrating the bisexual symbolism of the ear.
The act of listening contributes to super-ego and ego functions. A connection exists between voice and command. The prohibitions of the
adult become the 'voice of conscience'. Speech is taken in through the ear and ultimately the attitudes of the environment. The basic contribution, beyond that of words, which audition makes to ego development remains obscure, but it seems that the ears do help to develop many special skills. Hearing can serve as an emotional instrument. In respect to crude sounds hearing is similar to the sense of smell, which is largely repressed in civilized man, yet retains powerful affective associations. Auditory suppression is very important in sleep; dreams are usually soundless. The ears as a vehicle for language and affectively toned sound may be specially sensitized in certain individuals who later develop hysterical deafness. It is possible that unconscious attitudes concerning the ear may actually alter its physiology. The pathogenesis of certain ear disorders is unknown. Emotional factors have been implicated as precipitants in otosclerosis.