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This paper is concerned with the underlying character structure of hysteria and suggests that oral mechanisms play a more vital role in hysteria than has been generally assumed. Marmor reviews the concept of hysterical personality and cites the description of Wittels and the work of Wilhelm Reich. Oral mechanisms are prominent and tenacious in the hysterical character. The hysterical character is one of the most difficult to alter. This resistance to change, the immaturity and instability of ego structure, and the close relationship of hysterical character to addictions, depressions, and schizophrenia are best explained by the deep-seated oral fixations. The author admits the unquestionable importance of Oedipal fixations in hysteria, but believes they result from preoedipal fixations, chiefly oral, and he suggests that we look for the deeper pregenital oral wishes in hysterical patients. The fact that hysterical character occurs more often in women than in men is perhaps due to the more ready acceptance by society of passivity, dependency, and receptivity in women.
It is questionable that neuroses represent later stages of fixation than psychoses; probably an orally, anally, or phallically fixated individual is neurotic or psychotic because of quantitative variations in balance between strength of the ego and the strains upon it. The 'erotic' character described by Freud is approximately the hysterical character. Predominance of oral fixations favors the development of hysterical character.