A thirty-five-year-old man in analysis spontaneously associated an anxiety attack with a memory of a blow to the genitals. keiser postulates that this is not reported more often because the scrotal sac is less integrated into body ego and image formation than the penis. Damage to the penis remains the most significant dynamic factor. It is possible that the somatic symptoms of anxiety have their neurological basis in the reaction to a blow to the testicles.