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Dr. Adair's wonderfully vivid case study illustrates his theory of the conversion process. I agree with most of the major points made by the author and especially the notion that some conversions originate in somatic hallucinations. In my paper on this subject, I presented clinical observations and theoretical discussion about somatic hallucinations (Dorpat, 1968).
My clinical experience concurs with the author's idea that conversion symptoms can and do appear in a broad range of diagnostic group entities.
The author wisely suggests adding conversions to that group of clinical phenomena which oblige the analyst to carefully review and analyze his recent clinical behavior. My rule of thumb for evaluating all psychiatric symptoms (conversions as well as anxiety, depression, and other symptoms) that emerge during analytic sessions is to first consider how the analyst's interventions may have contributed to the pathological process ending in symptoms.
Another paper reports the results of a study of forty-one episodes of the conversion symptom of sneezing occurring during a period of sixteen months (Dorpat, n.d.). There was a reliably recurring pattern to the series of events preceding sneezing. First, there was the arousal of guilt over forbidden aggressive or sexual desires. This led to an unwelcome self-image. In an attempt to get rid of this discomfort, the memory trace of a foreign body in the nose was activated leading to a brief hallucinatory sensation within the nose. This irritating sensation triggered the sneezing. The sneeze thus symbolizes fulfillment