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PFR 3(1):69-83 (1967)

Migraine Headaches, Altered States of Consciousness and Accident Proneness: A Clinical Contribution to the Death Instinct Theory

Author: Melitta Sperling MD

Abstract

For the past 20 years, I have been engaged in the psychoanalytic investigation and treatment of patients suffering from migraine and other forms of psychogenic headaches. The majority of the patients reported in 1952, (23) came for analysis not because of migraine, although this was a prominent symptom of long standing, but mainly because they suffered from depression. In the analysis of these patients, I discovered that there was a dynamic relation between their migraine headaches and their depression. Subsequent work with migraine patients who came for analysis with migraine as the presenting symptom have provided me with additional material and a fuller understanding of the dynamics operating in migraine and has enabled me to study the relation between migraine and depression on the one hand and between migraine and states of withdrawal, petit mal and epilepsy on the other. (34)

In this paper I shall focus in addition to the dynamics of the migraine attacks, on two phenomena which occur with great frequency or almost regularly in migraine patients.

The striking accident proneness of the migraine patients and the equally striking change in this behavior in analysis. These patients usually display a repetitious pattern of similar accidents, with increasing frequency and severity, sometimes with very narrow “miraculous” escape from serious injury or death.
Altered states of consciousness with changes in perception in the visual, auditory or olfactory spheres preceding the onset of the migraine attack. (3) (10) (11) (12) (28) Some patients may experience sensations of dizziness, or faintness or even brief lapses of consciousness. The great need for sleep, which most patients experience preceding and during the attack indicates that they are under the influence of strong tendencies to withdraw from reality and points to a relation with sleep-states
Page 69
such as sleep walking, narcolepsy and with petit mal and epilepsy. These prodromal symptoms differ in severity not only wi

PFR 3(1):69-83 (1967)

Migraine Headaches, Altered States of Consciousness and Accident Proneness: A Clinical Contribution to the Death Instinct Theory

Author: Melitta Sperling MD

Abstract

In this paper I shall focus in addition to the dynamics of the migraine attacks, on two phenomena which occur with great frequency or almost regularly in migraine patients.

The striking accident proneness of the migraine patients and the equally striking change in this behavior in analysis. These patients usually display a repetitious pattern of similar accidents, with increasing frequency and severity, sometimes with very narrow “miraculous” escape from serious injury or death.
Altered states of consciousness with changes in perception in the visual, auditory or olfactory spheres preceding the onset of the migraine attack. (3) (10) (11) (12) (28) Some patients may experience sensations of dizziness, or faintness or even brief lapses of consciousness. The great need for sleep, which most patients experience preceding and during the attack indicates that they are under the influence of strong tendencies to withdraw from reality and points to a relation with sleep-states
Page 69
such as sleep walking, narcolepsy and with petit mal and epilepsy. These prodromal symptoms differ in severity not only wi