IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis

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for the creation of the accompanying situation. The accompanying anxiety shields the phobic individual from even greater anxiety of ‘anxiety-as-a-signal-of-not-having-anxiety’. The phobic does not avoid the phobic object. He seeks it. In contrast, the ‘phobic situation’ is represented by the loss of the desired relationship. For the phobic, anxiety is necessary, structuring, and rigidly maintained. It is the essence of the phobic’s life, his true ‘accompanying object’. The statement that the objects are interchangeable does not mean that they are not different from each other. The interchangeability occurs at the level of their function. The course of phobia is an exhibition of limitation, mutilation and castration. The true companion of the phobic is anxiety, and anxiety is the object. VI. Ak. Uruguay: Female Development from the Object Relations Perspective In Uruguay, a group of authors, closely linked to the work of the Barangers, studied hypochondria and feminine development from the Object Relations Theory perspective. Citing general observations and psychoanalytic experience Madeleine and Willy Baranger, Aida Fernández, Mercedes F. de Garbarino, Selika A. de Mendilaharsu and Marta Nieto (1964) found the universal presence in women of disturbances of a hypochondriacal type, related specially to their sexual functions, as a specific feature of female development. The fantasy known as that of the ‘sewer’ appears to be at the center of these disturbances and to correspond to a specfic type of “confusional” anxiety. The ‘sewer’ is felt as an intermingling of undifferentiated contents belonging to all levels of instinctual development (corporal substances, parts of objects, etc.). In certain cases, the ego reacts by isolating the ‘sewer’ within the corporal scheme and setting it up as a separate nucleus, contained within a ‘wrap’. This is expressed in fantasies which center on having a ‘bag’ or a ‘cyst.’ A frequent defense to ward off the anxiety which results from the ‘hypochondriac cyst’ consists in the belief of the possesion of a ‘ghost penis’, another alteration of the corporal scheme which is intented to deny hypochondriac anxiety. The ‘hypochondriac cyst’ seems to be related to ‘female masochism’, to marked erotism of the skin, to ‘narcissism’ in women and to their exhibitionism. It is normally overcome with the experiece of maternity, although it may also contribute to make maternity more difficult, and it occurs in all psychological or psychosomatic pathology of female sexuality. Marta Nieto (1960) wrote about the relationship between obsessional and hypochondriac defences. In her elaborate system of assumptions, thesis and conclusions, she includes the concept of hypochondria which embraces a variety of phenomena having in common the expression, through body experiences, of the relationship with internal objects, located in the body. Her studies result in wider understanding of obsessive neurosis based in the first place on a wider concept of analytic including phantasmatic relationships of expulsion- retention of any object through the intervention of any zone not only of the anus (“dirty mouth”. “dirty look”, etc.) and in the second place on the acknowledgement of the hypochondriacal foundation in many obsessive cases, since hypochondria implies indiscrimination of phantasies, impulses and zones. She hypothesizes that the presence of obsessive mechanisms


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