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Streitfeld examines Alexander's unsubstantiated theory that each of the various kinds of psychosomatic disturbance results from psychological factors specific for that disturbance. He attempts to determine whether patients with peptic ulcer differ from patients with psychosomatic illness not of the gastrointestinal tract in having conflict over intense wishes to suck or be fed and to bite or devour. He assumes that oral conflicts can be reliably identified by projective tests, principally the Rorschach test and the Blacky Pictures. Affective content of the Rorschach responses was scored by a special method. The subjects were twenty patients with peptic ulcer and twenty patients with psychosomatic disorders of tracts other than the gastrointestinal.
The two groups did not differ significantly in oral dependency. Conflict over oral-dependent needs is much too common to be considered a specific agent. The study did reveal that conflict over oral-aggressive wishes is significantly stronger in ulcer patients than in other psychosomatic patients. This difference, however, was not found consistently on all tests, nor was it significant at a very high level of confidence. Moreover, half the control group showed evidence of it. This conflict has been reported basic in many disease entities.
A wide variability in the defenses used by patients with ulcer was found by qualitative inspection of the data. The search for specific defenses appears to be fruitless.
The author suggests the following conclusion: 'Peptic ulcer patients do not differ from other psychosomatic cases in being frustrated in the gratification of their oral-dependency needs. Nor do they differ in the kind of overt personality they present to the world. Where they do differ is in their tendency to react with strong oral-aggressive wishes to the frustration of their oral-dependent needs. Other psychosomatic cases may indulge in such wishes, but they usually do not do so with the intensity or frequenc