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In women, the attack of migraine is stimulated by conflict over sexual desires that revive competition and anger toward women. The anger is repressed. Anxiety and guilt over these rivalrous feelings force retreat to a masochistic attitude. The migraine headache reflects this masochistic attitude; the head serves as a substitute for female generative and sexual organs and their functions. Specific displacement to the head is caused by the patient's identification with a mother who is herself strongly masochistic in intellectual function. The patient's adoption of a similar attitude depends both on direct identification with the mother and upon unconscious compliance with the mother's wish, also unconscious, that the child be masochistic intellectually toward men. Retreat from sexual conflict is further evidenced by anal regression, so that the Oedipal desire to have a baby with the father appears as the desire to produce an anal baby.
The same dynamic factors appear to operate in men with migraine. Their repressed passive homosexual desires are an identification with a masochistic mother.