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This study, as its title indicates, is a continuation of the investigations first reported by me (Sperling, 1952). I described migraine sufferers as predominantly orally fixated individuals with a very low tolerance for frustration. Although these patients appeared to be functioning well intellectually and sexually, their analyses revealed that they had not reached the genital level of libidinal development. This was apparent in their sexual lives and in their relationships with people. In the male patients premature ejaculation, preoccupation with and practice of sexual activities of a distinct oral character (cunnilingus and fellatio) were a main feature. In the women patients I found that their attitudes towards sex resembled their attitudes towards food. There were alternating periods of complete rejection of the sex act and of insatiability. Their oral fixation manifested itself also in their extreme inability to tolerate injury to their narcissism. The slightest injury provoked an intense rage reaction with an urge for immediate discharge. Acute repression of this rage served to protect both the external object, against whom this rage was directed, and the patient himself, against whom it was turned back. Their object relationships were characterized by marked ambivalence and sadomasochistic attitudes. Fromm-Reichmann (1937) has emphasized repressed hostility and ambivalence as important dynamics in the migraine patient.
In addition to the oral fixation, I stressed the very strongly developed anal sadism in these patients. The compulsive behaviour, muscle rigidity, tenseness, and other features are due to the reaction formations against anal-sadistic impulses. This description of the personality of the migraine patient, though correct, does not seem specific to the migraine sufferer. It could, and actually does, apply to sufferers from a variety of psychosomatic disorders. All these have one basic denominator in common: a pregenital character st