Meeting of the Association for Psychoanalytic Medicine

DISCUSSION: Dr. H. Robert Blank gave several illustrations confirming Dr. Altshuler's findings from his own investigation at a school for the deaf. His observations indicated a prominence among the deaf of egocentricity and impulsivity and defects in empathic capacity, object relationships, abstract thinking, and the ability to postpone gratification. His impression was that the average deaf adolescent was four to five years behind his hearing peers in reading and social behavior, though about equal in motor skills. In comparing the roles of vision and hearing in ego development, Dr. Blank assigned hearing a place between the tactile and visual senses in terms of contact and distance perception. The development of the early 'protopathic' ego probably depends on cutaneous and auditory, as well as oral, stimulation of adequate intensity, frequency, and rhythm. If stimulation is inadequate, the child's receptivity becomes dulled, its output motility is impaired, and the smoothly integrated and interrelated development of all ego functions is hampered. From about the fourth month of life, the increasingly refined and economical visual function assumes dominance in the sensory apparatus and at an early age becomes orally libidinized and aggressivized. As speech, language, and abstract thought develop, the early contact or affective aspect of hearing becomes the increasingly precise register of mother's feelings and the appraiser of the environment's pleasantness or unpleasantness. Because of these qualities auditory introjects are probably the chief source of intuition and empathic understanding. Visual cues may become efficient substitutes for these processes after they are established, but