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This paper is an expanded version of opening remarks to discussion of Dr Katan’s paper on ‘Fetishism, splitting of the ego and denial’ and Dr Meltzer’s paper on ‘The differentiation of somatic delusions from hypochondria’, read at the 23th International Psycho-Analytical Congress, Stockholm, 1963. All three papers were published in the International Journal of Psycho-Analysis 45 (2/3) (1964).
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 psychoanalytical 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 unconcious phantasy structure which acted as a ‘leitmotif-phantasy’, 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 th