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Interest in the manifold and devious ways in which intrapsychic and extrapsychic stresses can initiate, complicate, and intensify states of somatic disease, or psychosomatic medicine as it is now designated, is a subject which only recently has come to be a major focus of psychoanalytic attention. With the exception of Groddeck (8) and Stekel (11), few of the early psychoanalytic pioneers concerned themselves with this subject. Freud, too, except for his cases on conversion hysteria, gave it scant attention. And general medicine and psychiatry have hardly done better. The English psychiatrists, Tuke (13) and Maudsley (10), as early as 1870 discussed the remarkable way somatic changes could be affected by psychic stimulation but other than the work of Dejerine and Gauckler (3) in 1913, almost no further advances were made in this area until Cannon's epic work in 1923 (1).
More recently a whole generation of psychoanalysts have made the psychosomatic diseases their special field of study: Jelliffe, Alexander and his associates, and Felix Deutsch, to mention a few. This area of inquiry has afforded an unparalleled opportunity for physicians of diverse specialties and psychoanalysts to work together, and today several journals are devoted exclusively to reporting research in this field.
In all this burgeoning interest, it is a remarkable paradox, however, that the most common psychosomatic condition that exists remains with but scanty mention and little study by both physicians and psychoanalysts. I refer to psychogenic skeletal muscle hypertension, or, as I propose to call it hereafter, psychogenic muscular dystonia. Although it is the most common of all psychosomatic problems, I do not recall it being mentioned