The Psychoanalytic Quarterly, 23, 1954, No. 1: Catherine L. Bacon. 'Psycho-Analytic Observations on Cardiac Pain.'

Cardiac pain, frequently radiating down the left arm, has been observed in several patients in analysis during a conflict of receptive and aggressive drives. It is known that oral receptive strivings stimulate the parasympathetic and aggressive strivings the sympathetic nervous systems. The physiology of the heart is such that the combined stimulation of the two could easily result in cardiac anoxia. Now oral receiving often induces a sense of obligation and obligation a sense of defiance. If such a patient revolts against the donor (parent) he feels fearful, if he does not, he feels outraged at the loss of his freedom. In either event, if the conflict is severe and occurs with the patient in the vagal phase, cardiac pain may ensue from this concurrent stimulation of the sympathetic. This is theoretically much less likely to occur if tension can be reduced in either system. Interpretation should therefore be directed (a) towards diminishing the patient's oral guilt and anxiety arising from hostility, and (b) towards slowing down his reaction-time to oral-receptive stimuli and thus allowing the necessary time for psychic and physical digestion.