Meeting of the Psychoanalytic Association of New York

DISCUSSION: Dr. Mortimer Ostow noted that Dr. Sperling's observations about migraine and depressed patients were similar to his own. It was his experience that these patients suffer from disturbances of libidinal energies in the ego; thus many of them respond to some of the newer drugs. In migraine, there is

an abrupt impoverishment of the ego and as soon as equilibrium is achieved the headache disappears. The attacks are also associated with hypersensitivity of sensory modalities. Antidepressant medication is thus helpful in preventing migraine, whereas tranquilizing drugs often precipitate it in predisposed subjects.

Dr. Renato Almansi referred to one case of migraine that he analyzed in which he felt that the cure of the migraine attacks was due to analysis. In his patient, who suffered from monthly attacks from the age of seventeen, an important genetic factor seemed to be a meningeal illness that his sister suffered from when he was six. While in analysis, this patient, who had begun to gain more insight into his castration problems, after seeing an alligator developed a severe attack of migraine in the course of which he saw, in a hypnagogiclike fashion, an alligator surrounded by a halo. The attack then ceased and migraine headaches did not recur. Thus it seemed that the analysis deprived the migraine of the psychogenic mechanisms that would trigger the attack.

Dr. Jan Frank raised the question of somatic-psychic versus psycho-somatic. He noted that in 'petit mal' epileptic attacks one finds dysrhythmia in the EEGs and frequent attacks, which do not respond to medication, can lead to a brain syndrome with personality changes. But migraine attacks in adolescence, due to hormonal and autonomic nervous imbalance, sometimes spontaneously disappear after puberty without treatment. Dr. Frank said that caution should be used in regard to analyzing organic lesions or illnesses.

Dr. Gustav Bychowski spoke of his experience with a small number of 'epileptic'