Some Clinical Aspects of the Body Ego: With Especial Reference to Phantom Limb Phenomena

The repetitive nature of the patterns of the individual in his relationships with persons is well known and more or less easily demonstrated clinically. However, the extent and importance of the individual's repetitive relationships with his body image have only lately come under intensive scrutiny, especially in relationship to the ego's manipulation of perceptions and the problems of psychosomatic disease. Deutsch (10) has pointed out how bodily sensations during the analytic process are utilized by the ego in both expressive (instinctual) and defensive (ego) aspects. Many others have also dealt with various aspects of these problems (36-39). Postural, kinesthetic, auditory, visual, skin and visceral sensations can be looked upon as preverbal expressions of preconscious and unconscious thought processes which may or may not be expressed verbally. These sensations are modulated by the ego and work synergistically and antagonistically, individually and in combination in the service of ego stability. In this sense, an unconscious part of the apperceptive ego regulates autonomously or modulates sensory perceptions in order to satisfy the ego's needs of the moment.

For example, an analytic patient became preoccupied with the visual image of a shadow on the wall which he traced in detail, and then with the noise of a clock ticking. These sensory preoccupations were substitutes in the present for the recollection of a past traumatic event concerning the loss of a parent and aided him in the postponement of its remembrance and a gradual approach to the material. Noises and sights in the present defended him from noises and sights in the past. Sight may also defend against sound. An analyzand became preoccupied with the painful effect of light and resorted to dark glasses after hearing his parents discuss a portion of his infantile past of which he was very much ashamed. This discussion concerned his anxiety over noises in the night and particularly his mother's asthmatic a