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DISCUSSION: Dr. H. Robert Blank agreed with Dr. Jacobson's differentiation between guilt and shame, stressing its technical importance in the analysis of masochistic and psychotic characters, and the ubiquitous negative therapeutic reactions. He feels Dr. Jacobson's formulations are relevant to his concept, the masochistic body-image. By this term he means self-representation as a thin, fragile shell enclosing emptiness or dirty and destructive contents. With such patients it is essential to recognize the 'global' shame reaction. For them,. any revelation, action, or feeling is dangerous; nothing can be exposed; everything good is experienced as superficial, fragile, and false. Both self and object must be protected from the inner rottenness. 'This is primarily a narcissistic ego problem … complicated by Oedipal and later adolescent conflicts' and the working through of the massive shame reactions must precede definitive analysis of the Oedipus. Dr. Jacobson's formulations are also supported by Dr. Blank's experience with congenitally deaf persons who tend to suffer from defects in superego development and object relations.