You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In this paper Garma explains his hypothesis of the psychogenesis of peptic ulcer.1 Alexander supposed that rejected passive tendencies persist in the unconscious and take on an infantile character; an unconscious urge to be fed, representing the wish for mother's affection, provokes in the individual predisposed to ulcer a continuous secretion of gastroduodenal juices which irritate the mucosa. Garma believes that the cause of ulcer is the unconscious psychic representation of an aggressive and frustrating mother. This imago originates in infancy and forms part of the patient's superego. The patient suffers damage in the digestive tract because, as a result of inner prohibitions and frustrations, he has regressed from genitality to oral digestive behavior. This theory considers ulcer an illness precipitated by external frustrations and aggressions of many kinds which the patient is unable to reject because in his infancy he was obliged to accept the aggression of his parents. The patient fails to direct counteraggression toward external sources of hostility. Instead, the consequences of parental aggressions, especially those of the mother, are reactivated in him. These primordial aggressions are still active within him because they have been incorporated into his superego. The superego directs all aggressions, those coming from without as well as his own activated infantile ones, against the gastrointestinal tract. The instinctual regression is accompanied by regression of the superego and reactivation of the terrifying infantile images of the bad mother of the first month of life who, according to the fantasy of the infant, cuts the umbilical cord in an attack, deprives the infant of its nourishment, or gives it harmful foods, and also sucks, bites, claws or perforates the inside of the gastrointestinal tract, especially of the stomach and the duodenum. These cruel representations of the superego produce their effect upon the stomach and duodenum thro