Meetings of the New York Psychoanalytic Society

May 13, 1952. FOOD ALLERGIES AND THE UNCONSCIOUS. Melitta Sperling, M.D.

In the analysis of a thirty-six-year-old woman, suffering from severe dyspnea, coughing, and numerous food allergies with skin manifestations, it was found that certain foods had specific genital or pregenital connotations. The offending foods had become organized into unconscious fantasies which, prior to analysis, produced the somatic reactions, but with little anxiety. During analysis, on the other hand, emerging fantasies and impulses produced anxiety instead of somatic reactions. Analytic working through enabled her to tolerate these impulses without fear of acting out. Dr. Sperling suggests, 'The relation between ego strength, adequacy of repression and ability for conscious control is a dynamic factor in conversion'. A weak ego is unable adequately to oppose or to repress threatening impulses; under such conditions, conversion of the impulse into specific somatic symptoms and bodily expression occur. She stresses the specificity of such conversion in contrast to the concept of conversion symptoms arising out of nonspecific emotional tension. The apparently healthy sexual gratification this patient achieved was actually based on unconscious pregenital fantasies. A close tie between allergic reactions and perverse unconscious impulses is postulated.

In discussion, Dr. Schur commented on the unusual wealth of factual material offered by the patient, a situation prevailing in psychosomatic patients. He discussed the way in which an emotional conflict can produce the same allergic reactions as does an allergen. Conversely, the allergen (dye, etc.) can become 'loaded' with symbolism and produce allergic reactions. He questioned the specificity stressed by Dr. Sperling. Dr. Samuel Atkin considered the case more typical of a narcissistic neurosis than conversion hysteria, and referred to cases in which food phobias were the precursors of (or associated with) more malignant processes.