Meetings of the New York Psychoanalytic Society

January 12, 1960. REMARKS ABOUT AN ORAL CHARACTER DISORDER WITH BLANK HALLUCINATIONS. Max M. Stern, M.D.

This paper is based on eleven cases either analyzed or observed under supervision by the author. The majority were manic-depressive characters, the hypomanic

type predominating, and included cases of perversion, addiction, and fetishism. Most were males, often gifted artistically and intellectually, who seemingly showed a good relationship to their families. However, closer examination revealed a predominantly oral-sadistic character formation, with demanding, vengeful attitudes, temper tantrums, inability to give, paranoid trends, and hypochondriacal fears. Stern was led to consider these patients as an entity because of their similar blank hallucinations ('elemental hallucinations close to somatic perceptions occurring in a stereotyped way without appropriate external stimuli', and lacking content as to persons, objects, or events). These hallucinations, which usually occur during times of stress, rage, or anxiety, include not only the well-known Isakower phenomena and the blank dreams described by Lewin, but also phenomena during waking hours: sensations of swelling or shirking of the body, changes in size and shape of a room, oncoming gray or milky clouds, electric currents flooding the body, gritty or doughy feelings in the mouth, ominous noises, darkening of a room or its flooding with a peculiar light, and vestibular disturbances like dizziness or rotating on a disc.

Instead of being wish fulfilments of early nursing experiences, as suggested by Isakower, Lewin, and Spitz, Stern postulates that such hallucinations are repetitions of severe early oral trauma. Their positive elements of bliss and elation are denials and negations of anxiety and terror. Some of their negative elements, such as parched throat and sandy, gritty feelings in the mouth, point directly to oral deprivation and occur as a repetitive effort at mastery of past experiences, an