The role of primal scene and masochism in asthma

Early investigators, such as French (1939), observed that asthma patients need to repress their sexual and aggressive impulses in an attempt to retain their mother's love. Early traumatic experiences (Brown and Goitein 1946), illness, primal scene, death in the family, miscarriage or birth of a sibling have all been mentioned as precursors of asthmatic attacks. These factors are also of considerable relevance in the case material presented here. Emphasized in this presentation, in addition to the above mentioned factors, are critical aspects of primal scene traumatic experiences and their role in the subsequent development of sadomasochistic character formation. This sadomasochism plays a considerable role in the later eruption of asthmatic symptomatology. The crucial factor in the asthmatic symptomatology arises from the effect of the traumatic experiences which are associatively linked to these sadomasochistic fantasies. Clinical material of an asthmatic girl with learning inhibitions and sleeping difficulties is presented. She demonstrates a clownish sadomasochistic type of behavior reflecting a disturbance in her object relationships. During the course of analysis, it was revealed that specific unconscious fantasies, associated with early traumatic experiences, played a predominant role in the development of her sadomasochistic attitudes. These, in turn, were linked to her asthmatic attacks.