Self-enucleation and psychosis. Report of two cases and discussion

We report two cases of self-enucleation and the case histories of the two schizophrenic men who carried out this drastic form of self-mutilation. In a review of the literature and consideration of the case material, it is concluded that castration fears, failure to resolve oedipal conflicts, repressed homosexual impulses, severe guilt, and self-punishment are ubiquitous phenomena in such cases. However, we conclude that psychosis, most probably schizophrenia, with a severe disturbance in body image, are necessary variables in the act of self-enucleation.