Meetings of the New York Psychoanalytic Society

DISCUSSION: Dr. Phyllis Greenacre addressed herself first to the question raised by the author about why psychoanalysts have overlooked this phenomenon, thus coöperating with their patients' denial of even a manifest strabismus. She suggests this relates to the introjective-projective level of relationship of the infant. She thinks that the analyst has ample opportunity to observe the strabismus in the preliminary meeting of each hour, but dismisses it because he feels 'diffusely and preconsciously uneasy', since there is not the return of visual contact necessary for a feeling of acceptance. She agrees with Dr. Lipton that the analyst may not wish to be identified automatically with someone whose visual response seems 'shifty' and defective. In medical history strabismus was one of the stigmata of degeneration which, in combination with three or four more similar signs, was thought to forecast impaired mental development. Dr. Greenacre wondered if the frequent appearance of manifest strabismus at the age of two and a half or three might point to a possible relationship with other maturational problems of this age period, notably the gaining of sphincter control. In her studies of urination and weeping, she was impressed that vision and particularly focusing played a much more important role in the male's gaining of urinary control than in the female. It is conceivable that the appearance of strabismus in males of this age may be a response to this and other demands. Like Lipton, she has observed that problems relating to vision can cause faulty ego and superego formation, in