Morton Reiser presents an excellent overview of the application of psychoanalytic principles to the understanding of psychosomatic illness. He points out the need for further psychoanalytic observations of patients with physical illness. Alexander Mitscherlich introduces the interesting concept of 'bi-phasic defenses'. He feels that chronic somatic symptomatology occurs in persons who failed in a previous attempt at resolving their conflicts on a psychic level. Melitta Sperling comments on the frequent association of acting out and psychosomatic illness in the same patient. She feels that psychosomatic illness occurs in the analysis of an acting out patient when the analysis comes to be viewed as a threat to his pregenital character structure; breaking off analysis would mobilize intense separation anxiety. The patient submits to the analyst and stops his overt acting out, but continues the rebellion against the analyst via somatic acting out.