Mouth, Hand and Ego-Integration1

What Bertram D. Lewin recently called Oral Psychology is a complex subject, encompassing not only the familiar aspects of the oral drive in infancy and its vicissitudes in later life but also such remote aspects as oral eroticism and skin sensitivity (Fenichel, 1942), hypnagogic phenomena in states of fever (Isakower, 1938), the structure of delusions and finally a detail in the psychology of dreams, called the dream screen.

While one has to acknowledge the fact, that the work of psychoanalysts is not lacking in hard research and ingenious imagination, one still wonders whether its tentative and experimental character is sufficiently recognised, and whether generalisation will not come about before the comparative slowness of analytic practice has permitted the full re-examination and final assessment of innovations.

In his admirable study "Sleep, the Mouth and the Dream Screen", Bertram D. Lewin (1946) puts forward the view that in the sleeper's mind the psychic residue (unconscious memory) of his mother's breast is represented as a dream screen, on which the dreamer projects his dreams. He also thinks that, when falling asleep and regressing into an objectless, fetal state we pass through an early oral stage of mental organization. On this he throws a powerful light.

The difficulties which psychoanalysts have been facing when discussing mental processes of early infancy are caused by the absence of the familiar functions of an ego and superego, which through speech and other external indications reveal the psychic reality underlying human activities. The instincts themselves cannot be studied directly, they "are superb in their indefiniteness" and "we are never certain that we are seeing them clearly" (Freud, 1933).

Much, if not everything, therefore, depends on the detection of those early functions which either germinate from an inborn ego core (Jeanne Lampl-de Groot, 1947) or present themselves as the first results