Undisguised Oral Mechanisms*

The role that oral libido plays in personality development has been described in the psychoanalytic literature. Freud, Klein and particularly Abraham developed the concept of oral sadism. Ordinarily, confirmatory material is seen by analysts during the course of a prolonged therapeutic analysis. The case to be described offers the unusual opportunity of having a patient report fantasies and phobias which are very direct expressions of deep unconscious material. There is no need to draw on symbolism nor interpretation to arrive at manifestations of oral sadism. Nor is there any reconstruction to be formulated. With this patient there can be no question that her story was influenced in any way by suggestion since her thoughts were partly conscious complaints. They disturbed her and for that reason she revealed them. The case history is as follows:

The patient, a 14 year old white Protestant girl, was brought to the Bellevue Hospital by her mother on November 2nd, 1945. She was under observation until January 17th, 1946 and was then transferred to the Psychiatric Institute for further study and treatment. There she received insulin and electric shock treatment.

The purpose of this presentation is to present deep unconscious factors which are easily related to the patient's symptoms. The girl's mother, a petite, youngish looking woman who appeared well-composed and unemotional, gave us the following history:

“D. has a phobia for meat. It started 3 years ago. She wanted chicken for Thanksgiving dinner. I could not get it so we had roast beef. She got angry and refused to eat it. Ever since then, she has refused to eat meat, fish, fowl or eggs—anything which has to be killed. First, she lived on vegetables and fruits. Then she ate only cheese or such products which do not require any cooking. She bought these things herself and ate them at home, but did not eat the food which was in the house. For 3 months prior to admission, she refused to eat at home and only ate at soda