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Pankow's long study of the problems of body image is applied here to hysterical psychosis. She had earlier defined body image by two fundamental symbolic functions: 1, a dynamic link between body part and the body in its totality and 2, the ability to comprehend the content and meaning of such a dynamic linkage. In
the schizophrenic psychotic, there is dissociation and destruction of both these functions of the body image. Pankow regards hysterical psychosis as a nonschizophrenic psychosis involving difficulties only in the second of these functions of the body image. She presents cases in which the unity of the body was never in question but the functional meaning of its parts was not integrated. In her article she compares her views to the work of Arlow and Brenner, Joffe and Sandler, and Kohut. She notes also that there is a correlation between family structure and body image in hysterical psychosis. She does not find the severe oral traumata which occur with the schizophrenogenic mother. The father is not unavailable, as in the schizophrenic family, but often he is weak and struggles with his own perversions and inability to accept his genital role. Hence he creates areas of destruction in the emotional life of his children, leading to problems in identification and in the establishment of the second function of the body image. In hysterical psychosis it is not possible to use the economic, structural, and genetic categories which are most important in treating hysterical neurosis. We lack a metapsychology of psychosis since the ego is not comprehensible when undergoing such complete destruction.