Bulletin of the Menninger Clinic. XIII, 1949: The Structure of the Grotesque-Comic Sublimation. Annie Reich. Pp. 160–171.

Annie Reich attempts to explain the conditions which result in the success or failure of grotesque-comic sublimation. The comic effect results from an economizing of psychic energy. A sudden breaking through of instincts under conditions which make them acceptable to the spectator's ego is necessary. Only the laughter or the applause of the audience makes the comic's performance successful, i.e., overcomes the guilt feelings. The function of the comic is to master what was terrifying in the past. Thus it often has a double-edged character. Some form of disguise is necessary in order to hide the real instinctual aim.

In the patient studied by Annie Reich, disfigured and deformed objects were portrayed by the comic. In this way exhibitionism, aggression and self-punishment in disguise were combined, making the performance ego-syntonic. What is intended for the hated object is demonstrated on the comic's own body. Disapproval from the audience means that the disguise has failed and the actor stands disfigured or guilt-laden.

It seems that people talented in caricature and grotesque-comic acting have a tendency to self-exposure and confession which drives them to exhibit. The difference between the comic and the melancholic is that the latter has unconsciously introjected the object and the comic consciously imitates the objects of his hostility. Comedians remain dependent upon the external world to a very high degree because the external world has taken over the role of their superego and they must repeat their performances in order to maintain the equilibrium between superego and ego. This form of artistic sublimation differs from all other forms because of its proximity to the original instincts and the concomitant anxiety. Incomplete desexualization leads only to a partial victory of the ego, making the personality of the grotesque-comic performer extremely labile.