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January 17, 1950. THE BEHAVIOR OF THE STOMACH DURING PSYCHOANALYSIS. Sydney G. Margolin, M.D.
A twenty-two-year-old girl with a large gastrostomy of two years' duration was psychoanalyzed. During the course of her analysis (but not during the analytic sessions) studies were made of gastric motility, color of mucosa, volume of secretion, concentrations of HCl and pepsin. The patient's gastrostomy was necessitated by esophageal stenosis following a suicidal attempt by swallowing lye. Three patterns of gastric functioning were found: 1, uniform hyperfunction ('synchronized high activity'); 2, uniform hypofunction ('synchronized low activity'); 3, a state of asynchrony, or dissociation of functions. These patterns showed correlation with the patient's unconscious mental processes, and could be predicted by the analyst from his knowledge of the patient's psychic activity at a given time. Synchronized high activity seemed related to an instinctual need driving toward a break-through into consciousness, synchronized low activity, to strong reaction formation, and asynchrony, to 'defense mechanisms in the service of psychic equilibrium'. Margolin concluded that such studies as this constitute one method 'of verifying psychoanalytic data and of validating psychoanalytic theory'.
Dr. Lawrence S. Kubie agreed with the conclusion just quoted. He stressed the fact that the various states of gastric functioning were found to correlate with unconscious, rather than conscious mental processes, and also that one must be cautious in assuming that the stomach of a person without a gastrostomy would respond in the same way as that of this patient, since in her, her stomach