In the psychotherapy of five adolescent boys, and observation of fifteen others, preoccupation with automobiles represented problems of self and body image and identity synthesis. Conflict over masturbation was the central theme in a reckless driver with a long history of conversion hysteria manifested by motoric disability. A depressed boy who favored small foreign cars contemplated suicide by asphyxiation, using the car's exhaust. A passion for 'customizing' cars characterized a lad with marked bisexual conflict, body anxiety, concern with his own appearance, and strong pregenital fixations. Another boy revealed a long history of preoccupation with body defect. A 'hot-rodder', who emphasized speeding, dangerous driving, and evasion of the police, struggled with Oedipal conflicts.

The therapist's interest in such highly cathected material was used to establish the treatment relationship and served as a base for the psychotherapy.