Meetings of the New York Psychoanalytic Society

November 29, 1960. SOME OBSERVATIONS ON THE ROLE OF THE SCROTAL SAC AND TESTICLES. Anita I. Bell, M.D.

Dr. Bell draws attention to the fact that very little has appeared in the psychoanalytic literature concerning the role of the scrotal sac and the testicles in personality and symptom development. The special anatomic and physiologic characteristics of this organ do not, of course, diminish the importance of the penis. Because the scrotal sac and contents are larger in the infant than the penis and occupy a position between penis and anus, there exists the likelihood of confusion between testicles and feces as the child observes his defection. They may, therefore, play a role in the male castration complex. The author postulates that this construct is rarely heard in analysis because of the particularly high degree of repression, denial, and displacement to the penis. As the testes are paired, they are often equated with breasts, labia, ovaries, and may also play a role in problems related to female identification.

In the normal male the testicles are unique in that they are the only organ which can disappear (into the abdomen via the inguinal canal) and reappear. This facilitates their equation with feces, and increases their involvement in the castration complex. Also, as the infant observes his bowel movement, he associates the dropping of the feces with the possibility of dropping (losing) the testicles. Because of this confusion, the child may associate pleasing his mother by producing a bowel movement with the possible loss of his testicles.

Several clinical cases are cited. One involved a very tense, constipated child. His symptoms were relieved when the occasional disappearance of the testicles was explained to him. An adult male had severe castration anxiety which developed in a family setting in which he was the only male. In frequent slips of the tongue he associated testicles with breasts, and later, ovaries, and blamed his mother for his la