Meeting of the Psychoanalytic Association of New York

DISCUSSION: Dr. Max Schur disagreed with the author's postulate and did not feel that it was supported by his own work or that of Margolin and Fenichel. In The Metapsychology of Somatization, Dr. Schur assumed that on the one hand desomatization of response to certain excitations is an essential part of maturation and, on the other hand, a resomatization of responses may be encountered in states of ego regression. 'What is resomatized is not an organ but the response to affects and conflicts; the nature of the response is determined by genetic and environmental factors.'

Dr. Melitta Sperling felt that Dr. Savitt had not given enough consideration to certain dynamic factors that are essential in the recurrence of psychosomatic symptoms in analysis, such as change in the quality of object relations with a shift in object cathexis and concomitant changes in superego structure. 'What occurred in the analysis at the time Dr. Savitt's patient had a recurrence of the ulcer was a change from the fetishistic to the psychosomatic type of relationship.' Dr. Sperling commented that she considered psychosomatic symptoms as pregenital conversions.

Dr. Gerald Freiman felt the paper was a valuable contribution to the literature on the classical treatment of male homosexuality and on the body-phallus equation. He also commented on Dr. Savitt's original way of using the concepts, phallic re-enforcement and anal hunger. He felt the paper could have been better titled, Transference, Somatization, and Phallic Re-enforcement. Dr. Philip Wilson stated that he had found specific etiologic fantasies of an oral incorporative nature in the analyses of ulcer cases. Dr. Sylvan Keiser commented that the symptom of body swelling was an interesting but common phenomenon. He felt that female patients might offer an opportunity to learn more about sensations of body swelling as they experienced them premenstrually.