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In the course of psychotherapy, symptoms may disappear without ever having become the specific object of the analytic process. They become unnecessary when the patient grows less anxious with his increasing ability to communicate and therefore acquires more adequate forms of expression. On the other hand, the redistribution of tension which takes place during therapy often makes it necessary for the patient to form new symptoms before he has arrived at ego-acceptable means of integrating his instinctual impulses. These processes were observed during the treatment of emotionally disturbed children living in the therapeutic milieu of the Orthogenic School and the following paper is a preliminary report on the fluctuations of their somatic symptoms during the process of personality integration.
For some children, life in a therapeutic environment made it possible to convert autoplastic mechanisms into outwardly directed activity. In others, personality growth in terms of a greater ability to internalize tension led to the emergence of autoplastic symptoms which had never appeared before. Such changes generally occurred during the process of personality integration, but they appeared much more readily in children who lived in a setting which was therapeutic in its totality.
Delusional preoccupations of various kinds were given up relatively soon. Psychosomatic manifestations of long standing—such as allergies, neuro-dermatitis, ocular-motor disturbances, mucous colitis and other disorders of the digestive tract—also disappeared spontaneously. Six of the eight children who wore glasses at the time of enrollment could dispense with them within their first 3 months at the school. These children were actually slightly myopic or astigmatic, but their visual dysfunction had been out of proportion to the visual defects. The visual defect of one