Discussion of Melitta Sperling's Article, Somatic Symptomatology in Phobia: A Psychoanalytic Study

Melitta Sperling's paper aroused my interest and admiration. It also stirred hope that psychoanalytic work with children will further encourage a resolution of the unscientific squabbles which have beset our profession. For it is an observable fact that in babies and young children emotional expression and body function are intimately, indeed inextricably, interrelated. The two-year-old with paroxysmal tachycardia, described by Dr. Sperling, provides an unusually vivid demonstration of how dangerous it can be to ignore what has come to be regarded as a truism.

Truisms about psychosomatic disease and the psychogenic aspects of organic disease do now abound. It has become a sign of the up-to-date physician or pediatrician to give evidence of an interest in the interaction of mind and body. Unfortunately, truisms tend to be used to express interest

while ensuring that no further enquiry shall be made. It is therefore salutary that Dr. Sperling should remind all of us psychoanalysts, and I hope our more physically orientated colleagues too, that mind and body can be simultaneously disordered and that the body's weaknesses can be exploited as a defense against self-awareness.

But I am not so content with Dr. Sperling's use of the word “phobia” to denote intense persecutory anxiety, even though this widening of the use of the word from its classical Freudian meaning has the advantage of drawing attention to the psychotic element underlying even the most ordinary phobias of everyday life.

As I have already indicated, one of my responses to this paper was to hope that work on tiny children, who are chronologically very close to the emotional roots of their mental and physical life, would diminish the misunderstanding between the various groups of Freudian psychoanalysts and thus open the way to further discovery.

An area of interest to me as a psychoanalyst trained in the Kleinian method is the role of projective identification in normal and abnormal development. The concept