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Alexander and his co-workers report their findings in a study of thirty-three cases of rheumatoid arthritis. It was found that the women had a tendency toward bodily activity, an inclination toward outdoor sports and that they showed a strong control of all other emotional expression. Their dependence upon other persons was masked by service and activity, overtly masochistic in character. Towards their children they were demanding and exacting. They rejected the sexual feminine rôle, showed masculine protest reaction, competed with men, and could not submit. Their husbands were usually passive men, frequently with physical defects.
It was found that unconscious rebellion and resentment against men activated the disease. It also seems that in situations where self-sacrifice and service to others does not succeed in keeping guilt feelings satisfied, the disease breaks out anew. In a third situation a masculine protest reaction was intensified in order to serve as a defense against a fear of sexual attack.
In the deeper analytic material the masculine identification appears at times through the utilization of the neck or limbs, or of the whole body as phallic