Pain as a Reaction of Defence

As is indicated in the title, pain has been the prominent symptom in this case and that without an adequate physical basis. The history is presented in some detail because it seems to show rather clearly the mechanism by which a physical is frequently elaborated as a result — in a certain type of personality — of a more or less conscious moral conflict. In this case the writer feels that attacks of pain, of the nature to be described, have acted as a way of escape from the intolerable situation created by the action of conflicting forces in the patient's personality. It was her defense indeed for a line of action, which — without some such justification — she herself would admit to be evidence of great weakness. This was, in short, the total failure to take her place in her home — the patient being a married woman, thirty-eight years of age and the mother of four children.

Before going on to the history itself several points may be noted in regard to some common characteristics of such cases which are suggestive of the genesis of the conflict. Firstly the very existence of such a conflict implies a failure in the process of organization of the personality around one main line of activity or interest which normally occurs during the period of adolescence and which is so necessary if the individual is to be an efficient social unit. This failure will most frequently be evident in the persistence of a childish attitude in relation to the environment or childish type of emotional reaction, or the clinging to a relationship which changed conditions renders impossible. This means that the essential transition from adolescence, from childhood to maturity, has never really occurred because the qualities it involves have not sufficiently developed. This failure being largely developmental, all factors such as defective heredity, poor physique, unfortunate early environment, have their influence, the most important possibly being a lack of early training in habits of self-reli