Psychogenic urinary retention

The literature on psychogenic urinary retention is reviewed. 2 cases treated by analytical psychotherapy are reported, in which significant demand for physical punishment was revealed and seen as linked to unacceptable, unconscious sadistic and aggressive feelings. Some psychodynamic aspects of what is considered to be "a disturbance of internal body space' are discussed. Psychogenic urinary retention has received little attention in the literature. It may represent the uneasy position this disorder of bodily function occupies in clinical practice, with clear physical symptoms and associated psychological factors. The condition is more frequent in females, usually young adults. Case histories regularly record the placid, passive presentation of these patients, childhood enuresis and disturbed backgrounds. The diagnosis, "hysteric', is frequent and most psychodynamic evaluations suggest the symptom represents a displacement of unacceptable sexual wishes and impulse. 2 patients treated by analytical psychotherapy are reported who, whilst fulfilling many of the criteria already noted, additionally revealed an intense desire for physical punishment. This punitive demand had less to do with unacceptable sexual wishes, than guilt at repressed aggressive drives of considerable magnitude. The role of aggression in the genesis of psychogenic urinary retention has so far been little studied.