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The author recommends the psychoanalytic approach to the treatment of psychosomatic illness. Supportive treatment only intensifies the unconscious use of the symptom as defense and for control of the omnipotent person. An extensive
case report is given of a forty-four-year-old man with a chronic regional ileitis of over twenty years duration. The Rorschach revealed a schizoid personality with defenses of intellectualization and withdrawal. The examiner advised against analytic therapy. The symptoms began when the patient left his mother for school. In comparing his symptoms to those of a patient with ulcerative colitis, the author found a marked tendency to spasm of the intestines rather than the colon, and diarrhea was less intense. Blood and pus were absent from the stools and there was no anorexia. The fixation point was in the anal-retentive phase with underlying obsessional, hypochondriacal, and schizoid features. In the ulcerative colitis patient, the fixation point was in the oral sadistic phase with underlying depression.
Three years after the termination of three years of analysis, the patient remains symptom-free.