This case report and discussion is based on twenty psychotherapeutic sessions and includes a review of the confirmatory literature. The theoretical conjectures are supported by inadequate material. It is Coodley's contention that psychological factors played a major role in the causation of the symptoms.

The patient was severely traumatized in childhood by maternal rejection and a castrating father. He reacted with oral dependency and a partial homoerotic object choice. In an army situation he responded to a potential homosexual attack by a father surrogate with passive submission and cataplexy. Subsequent attacks resulted from verbal aggressions against men which provoked laughter. The symptom represented passivity and homosexual acquiescence as well as the defense against them. The narcoleptic attacks in this patient seemed to represent unconscious wishes during a somnolent state to return to a childhood fantasy of an incestuous relationship with an older sister who was accepted as a mother surrogate.