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An actual precipitating conflict is of great importance in the genesis of peptic ulcer. In seven analyzed cases two factors were found to coincide: 1, there is dependence upon a woman, but genital life with her is unsatisfactory; 2, professional activity demands great efforts. In the patient's unconscious exist psychic images of an internalized mother that harm him in his digestive tract because he has partially regressed from a genital to an oral-digestive level. The resurrected, hungry, frustrated, infantile ego feels that the mother or breast is doing the exact opposite to feeding it; she is sucking it inside or biting it internally. Such a regression is outstanding in the psychoanalytic explorations of peptic ulcer patients and such imagoes are readily reactivated by exposure to aggression from the outer world. Four detailed cases illustrate this.
The harmful, internalized mother is unconsciously equated with harmful foods. This fantasy occurs not only in patients with ulcer but also in those with other digestive disturbances, as we might expect since between ulcer and digestive normality there are intermediate degrees of ulcer syndromes and other digestive syndromes without organic lesion that antecede the appearance of the ulcer. The aggressive character of the internalized mother is far more pronounced