A Psychosomatic Theory of Thyrotoxicosis. George C. Ham, Franz Alexander and Hugh T. Carmichael. Pp. 18–35: A Psychosomatic Theory of Thyrotoxicosis. George C. Ham, Franz Alexander and Hugh T. Carmichael. Pp. 18–35.

According to the investigations of the Chicago Institute for Psychoanalysis, it seems that patients with thyrotoxicosis have been exposed to early insecurities and have developed a chronic fear of death. Rejecting attitudes of parents, broken homes, excessive number of siblings, or the fact of being the eldest child make the patient unable to allay these insecurities through gratification of dependent needs. They make desperate and premature attempts to master insecurity by taking care of themselves and frequently of their younger siblings; they suffer from an excessive urge to perform in order to control the situation and to master fear; in short, they slip into a precocious maturity. This continued effort to mature and to be self-sufficient, which constituted a chronic emotional stimulus, was considered of outstanding importance in a group of twenty-three patients studied at the Institute. With what amounted to a counterphobic attitude, these patients attempted to persuade or reassure themselves that they were not afraid of death. In women the struggle against anxiety caused by frustrated dependent needs manifests itself primarily in the wish for children. Fear of death appears directly in dreams in which they see dead persons or are drawn into caskets. Suppression and repression of hostility caused by guilt over excessive sibling rivalry is typical and is again based on fear of death. The actual thyrotoxicosis develops when the defense breaks down and the patient is no longer protected against anxiety.