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DISCUSSION: Dr. Ludwig Eidelberg thought the use of the terms 'abstract' and 'concrete' thinking pertained to only part of the problem, and suggested the use of 'descriptive' and 'explanatory' thinking. Dr. Keiser's patients made use of descriptive thinking as a defense—defending themselves against vagina envy. They not only feared a lack of penis but also feared to admit seeing the entrance into the vagina. Dr. Eidelberg noted that free association is only a tool to obtain unconscious material; because of infantile omnipotence these patients did not tell everything but thought the analyst would understand. Such patients have to learn that the analyst does not know everything.
Dr. John Frosch spoke of a similar case where a patient's inability to perceive and conceptualize the female genital as a body organ led to a denial of all orifices and a fragmentation in the body image with impairment of ego unity, speech, and thought. He regarded the fusion fantasies as regressive phenomena to deny castration anxiety. In Dr. Keiser's patients, he felt that a major impairment of the capacity for abstract thinking would have to be accompanied by other ego disturbances, particularly as the relationship between mother and child had been a disturbed one. He postulated a generally fragile ego which regresses easily and dedifferentiates in unstructured situations, such as analysis, with development of womb fantasies (fusion fantasies).
Dr. Otto Sperling commented on the fantasy of fusion with the breast and believed it to be a variant of Bleuler's appersonation: 'that which is outside of the boundaries of our physical and mental ego is thought of as being within the ego boundaries'. Stressing the rejection by the mother, Dr. Sperling believed the fusion fantasy and disturbance of thinking to be regressive phenomena caused by the rejection.
Dr. Sidney Tarachow felt that as identification with the mother was impossible because of castration anxiety, a union with the mother occ