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April 5, 1965. DERIVATIVES OF COPROPHAGIA. Sidney Tarachow, M.D.
Dr. Tarachow discussed some clinical phenomena which he feels are too frequently neglected by both patient and analyst. Included under the heading of coprophagia and its derivatives are picking or scratching of the anus, skin, or mucous membrane; hair pulling; eating of secretions and products derived from the body; smearing or playing with one's own feces; saving or retaining the stool. Often this material is not reported until late in the analysis, perhaps due to the shame (rather than guilt) associated with such behavior. Also related to these phenomena are certain perceptions and attitudes toward time, some types of quarrelsomeness, and obsessional thinking. Clinically these phenomena are linked with the obsessional neurosis and character, and to depression. Dr. Tarachow emphasized the intense narcissistic quality and impaired object relations associated with patients exhibiting coprophagic derivatives. Genetically he focused on the determinants at the anal stage of development when the ego is struggling with two main problems: separation from the mother and separation from the stool. Anal separation is closely connected to the child's narcissism and megalomania; unwise or premature intrusion during development may have disastrous results.