You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The importance of the process whereby one part of the body is made to symbolize another part of the body is recognized both in psychoanalysis and in psychosomatic medicine. Such symbolic equations, and the substitutions which functionally implement them, have been studied by many experts. Nonetheless, relatively little is known about their actual genesis and about their first overt behavioral implementation, in actions which often resemble defensive improvisations in a situation of stress.
The purpose of this paper is to describe what was probably the first appearance, on the behavioral level, of the symbolic equation: face = vulva, in a woman patient undergoing a routine pelvic examination, as part of a general physical examination, for which she presented herself because of a variety of (largely psychosomatic) complaints.
It is one of the author's duties to observe how selected fourth-year medical students (assigned to the Comprehensive Medical Care outpatient clinic of Temple University School of Medicine) examine new patients, and to study the interaction between them and their patients. The observations about to be reported were made while a medical student was performing a pelvic (vaginal and rectal) examination on a patient. Data concerning the localized pelvic responses of the patient were furnished by the medical student, since the author