Comment on Dr Katan's and Dr Meltzer's Papers1

Both Dr Katan and Dr Meltzer have taken a symptom as the point of departure for the presentation of the conceptual tools they use in their clinical work. It is obvious that their psycho-analytical theories differ greatly, Katan's thinking being based on Freud's work, and Meltzer's on Klein's, particularly on her latest theories. I shall be able to select here only a few points from a rich offering.

In one of my patients, fetishism formed part of a polymorphous sexual condition which included the urge and capacity for normal heterosexual intercourse. This is in keeping with Katan's remarks about the importance of pre-oedipal conflicts for fetish formation. The fetish in my patient was women's stockings, and particularly their seams which not only symbolized the female phallus but also stated—emphatically, one might say—that the parental couple had identical genitals. Many instances in the analysis revealed the patient's confusion about the sexual character of his parents: in looks, manner, and work his mother appeared to him as masculine and on the same counts his father as feminine. At the same time, as a piece of clothing this fetish suggests the 'pre-traumatic fixation' elaborated by Katan.

My patient's history was reflected in an unconscious fantasy structure which acted as a 'leitmotif-fantasy', determining his unconscious self-image and thus large areas of his attitude to life. It revolved upon being deprived of security and love, upon having come too short of the need-fulfilling presence (rather than person). His private saga, built on information and memory, started with the very beginning: precipitate birth, short breast-feeding from inverted nipples (in many dreams odd mountains figured with a dent at the top instead of a peak), weaning coinciding with the loss of the mother's presence, since she resumed her work outside the house, a number of nurses who, according to their reappearance in the transference, were lacking in sympathy, intense homesick