Bulletin of the Philadelphia Association for Psychoanalysis. IX, 1959: The Role of a Birth Injury in a Patient's Character Development and His Neurosis. Elizabeth A. Bremer Kaplan. Pp. 1-18.

A patient in analysis had had right-sided paresis since birth. From the beginning of his analysis two character traits were especially prominent,—passivity and a persistent wish to please and placate the analyst. These traits were found to be closely associated with his birth injury, his parents' attempts to handle the problems imposed by the deformity, and his own reactions to these circumstances. The patient thought himself different from his father and tended to identify himself with his mother. He developed excessive castration fears: masculinity for him was dangerous both with men and women. The patient's chief defense was projection. His passivity proved to be an expression of aggression and a desire to punish his parents.

Physiotherapy had produced remarkable results for this patient, whereas insufficient attention to his psychological needs had permitted severe emotional crippling with constriction of ego and lack of sublimation. Analysis enabled the patient to diminish his pathological defenses and thereby to achieve a greater degree of independence and to assume a more masculine role.

There are few psychoanalytic case reports on patients with physical handicaps, especially birth injuries. Analysis of such handicapped individuals may contribute significantly to ego psychology.