The Concept of the Damaged Body in Psychosomatic Complaints of the Genitourinary Tract

This study was initiated by our interest in psychosomatic disturbances of the genitourinary tract.2 As a starting point we reviewed the records of 1,200 consecutive patients accepted for therapy in a Veterans' Administration mental hygiene clinic and found 55 patients with either major or minor genitourinary complaints. Symptoms referable to all systems of the body were included with the genitourinary complaints. Since our observations were principally made on male patients, no attempt is made to discuss genitourinary problems arising in females.

After discarding eight cases in which the data were insufficient, there were 47 cases, consisting of 45 males and 2 females, in which it was possible to obtain some understanding of the urinary symptoms involved.3 The patients could be divided descriptively into three major groups. One group, comprising 15 cases, had relatively minor symptoms. In this group it could be seen that the urinary symptoms served principally as an affective emotional expression. A larger group, comprising 27 cases, fell into a “borderline” group. The idea of being damaged was common to these patients, who were designated as having “organbound psychoses.” There was a group of five patients who were psychotic, although not all of them required hospitalization.

As to urination itself, it is accepted that this is a vital physiologic function and the whole process has “implicitly or concealed within it a psychical process.” (2) Urination may serve, aside from its excretory function, to symbolize aggressive and erotic feelings and anxiety. Further there would be manifestations of affective expression such as anxiety, rage, weakness, helplessness, guilt, joy and combinations of these. The urine itself may have special symbolic meanings, such as other bodily fluids, which will not be discussed in this paper.

The following are examples of urinary tract symptoms of a minor nature that accompanied anxiety or ag