A Note on Migraine

The patient who helped me to understand her defensive use of this complaint and, by so doing, greatly lessened its severity in her, had long suffered, intermittently, from a typical form of it. That is to say, the attacks began with a sense of partial blindness, as if her view were obscured by a dark area, after which jagged, blinding lights appeared, and ended, after these had gone, in an acute headache which gradually wore off.

It had already become apparent, during the course of some years of analysis, that the migraine was affected by psychological factors, and, in particular, that it tended to become worse whenever the analysis itself was felt as, in a high degree, emotionally disturbing. I had once suggested—on what grounds I am afraid I no longer remember—that she felt her migraine to be analogous to the blinding light St Paul saw on his way to persecute the Christians and that it was therefore related to her own unconscious sadistic phantasies. But this was all I could discover, or guess at, until a particular dream gave a much more specific clue. This followed a period of unusually frequent and severe attacks during which she had been trying to face, and adjust herself to, an actual calamity in her life. In the dream, 'she was outside her own house. Her mother (who does not, in fact, live with her) was inside and calls her in. She goes in, with strong feelings of love (such as she could hardly remember actually feeling for her mother.) Her mother is bending down by an electric wall plug, and seems to be small. But then she becomes small, too. Her mother looks at her and says she cannot bear the terror in her eyes. Then she looks down and, to her horror, sees that her mother is about to electrocute her with two wires.'

All I could at first see in this was a link with a dream of the previous night in which 'she had been able to tell a woman, who was symbolically in the relation of a mother to her, about the actual calamity (I mentioned).'

In fact, she