The Psychoanalytic Quarterly: I. Peter Glauber. 'A Deterrent in the Study and Practice of Medicine.'

The author examines the neurotic countertransference to their patients of five doctors or medical students. Their difficulties resulted from a confluence of oedipal identifications determining their choice of profession with unsublimated part-object identifications. Typically the part-object was the breast, and ablation of the breast, representing the separation of the self from the mother, was the typical therapy. Its aim was the cathexis of the ego. The oepidal identifications could not function adequately, partly because they took the form of inhibitions, and partly because the solution of the regressive conflict was prerequisite. The abortion of the capacity for identification resulted from trauma at the narcissistic object-finding stage. It was noteworthy that in most of these patients feeding was experienced simultaneously as a libidinal gratification and as an aggressive attempt at reincorporation. The fear of reincorporation mobilized further aggression in the shape of a defensive increase in oral activity, scoptophilia, and general motility, the motility being equated with the emergence of a differentiated self, or birth. In so far as identification presupposes relinquishment or transformation of aggressive energy the capacity for it was still further impeded.

This conflict of ego regression and progression was reflected in necrophilic ruminations. The reattachment of the libido to the mother was represented by the image of the clutching cold mother, projected on to inanimate nature in the form of liquids and semi-solids, e.g. quicksand, water. The other side of the conflict was represented by the image of the 'dead' mother who gives birth to, or liberates, the child, and was projected as solids, e.g. the elation of loitering amid ruins. Such projections may affect the attitude of medical