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In her opening remarks, the Moderator stressed the importance of the role of the body in ego development. Modern psychoanalytic trends have been shifting our attention away from the body and its drives, as object-relations theories have been growing in influence. Hartmann underscored Freud's distinction of the drives as body-rooted phenomena—ruled by the pleasure-unpleasure principle—from their psychic representation as ideas.
Elisabeth Brainin, training analyst of the Vienna Psychoanalytical Society, and former executive director of the City of Vienna Child-Guidance Clinic, talked about the body ego in the course of psychic development. Quoting Damasio, Brainin reminded the audience that sensations, in contrast to feelings, ‘are first and foremost about the body, in that they offer us the cognition of our visceral and musculoskeletal state’. Phenomena like defence and resistance—let alone impulses—are often accompanied by somatic manifestations.
Brainin brought forward several observations to illustrate the repercussions of body maturation on ego development. She commented on the reaction of a girl to the change of diapers that she seemed to experience as a painful loss of a bodily part, equivalent to castration. Brainin hypothesised that the feeling of castration that results from the regular removal of diapers takes on additional meaning après coup with the beginning of menstruations. Menarchia is often experienced as loss of sphincter control, which tends to be perceived as shameful and shocking to the girl's narcissism. Body orifices are transitional zones between inner and outer perception. In their capacity to control what enters and exits, the sphincters are especially cathected areas. Feelings of autonomy and narcissistic identity are developmentally related to sphincter control. Since the vagina has no sphincter, it is impossible to control voluntarily what comes out of it.
The emotional and behavioural instability of the premenstrual syndrome would be ‘the a