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The problem of migraine and psychogenic headache has attracted considerable psychiatric attention. A number of psychiatric investigators in their studies of the psychological aspects of this syndrome have noted a definite relation between the frequency and intensity of the migrainous attacks to anger, resentment, disappointment, criticism and frustration in work, etc. Selinsky (1) stresses anxiety and resentment as the prominent emotional forces in migraine and considers attacks of headache as a “physical expression of inhibited protest carried out in a morbid manner.” In a psychoanalytic approach to this subject, Frieda Fromm-Reichman (2) arrives at the conclusion that migraine is an expression of deeply repressed hostility against a beloved person, occurring in patients with an unresolved ambivalence conflict. Various authors (3, 4, 5, 6, 7) in personality studies of migraine patients have described a variety of neurotic features such as rigidity, tenseness, sensitivity, ambition, submissiveness, domineering behavior, etc. These features are not pathognomic for migraine sufferers however, and because of the method by which the material has been studied (conscious attitudes of patients), no genetic correlation to infantile attitudes can be made.
The present study which utilizes the insight gained from the psychoanalytic treatment of fourteen adult and nine child patients in whom migraine and persistent or recurrent headache have been a prominent symptom, is an attempt to contribute to the clarification of the psychodynamics and mechanisms of migraine and to an understanding of the personality structure of the migraine patient. Fragments from the analyses of three adult and two child cases may illustrate my points.
Mrs. A., a woman of thirty-six, came for analysis because of a chronic depression with psychosomatic equivalents. Among her many physical symptoms, most painful was a severe migrainous headache of long-standing. Under treatment for many years for