Most theories of psychosomatic disease fail to account for the choice of somatic discharge. Wisdom has before proposed that a disorder becomes psychosomatic if the conflict involved is experienced in terms of tactile and kinesthetic sensations, rather than as visual imagery. Disorders such as diabetes are difficult to explain on this basis. In the present paper, Wisdom enlarges his hypothesis to cover those psychosomatic cases that do not show guilt or anxiety. In all psychosomatic cases, there is some unconscious concept of an attack by an internalized