This clinical study uses the frame of reference of the transference neurosis in order to determine what role object relations have for the satisfaction of drive needs and the total psychic integration of a patient who suffered from two somatic syndromes, migraine and hypertension.

Drive needs and object relations are conceptualized along a continuum, a hierarchy whose spectrum extends from primitive omnipotent megalomanic, primary process modes of operation to judgemental reality-tested sensory and motor phenomena that are organized in a secondary process fashion. The somatically oriented drive needs in a primitively fixated or deeply regressed ego do not have a mental representation, since the qualities of mentation and consciousness relative to such basic needs are still embryonic. At the other end of the spectrum, the drive is experienced as a conscious impulse that can potentially be gratified in an object-directed fashion.