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Psychosomatic Medicine 1:153-161 (1939)
© 1939 American Psychosomatic Society

Hostility in Cases of Essential Hypertension

LEON J. SAUL M.D.1

1 Institute for Psychoanalysis, Chicago

An attempt is made to describe the common psychological features in seven cases of essential hypertension. The prominent similarities are 1) the prominence in every case of a dominating mother, with submissiveness and oral dependence toward her, transferred in the cases of the two men to their fathers; with consequent chronic, hostile, unsuccessful, nearly conscious rebellion against the submissiveness, and chronic unexpressed rage at unsatisfied oral demands and at independent activity and work; 2) marked inhibition of heterosexuality, although indulged to some extent despite anxiety; 3) the status of the hostilities--intense, chronic, inhibited, near to consciousness and perhaps to motility, not adequately expressed, and not adequately repressed and bound as by an organized neurosis; 4) the inability to accept and satisfy either the passive dependent wishes or the hostile impulses, so that these individuals were neither weak and dependent nor aggressively hostile, but were blocked in both directions. During periods when either trend was more satisfied, the blood pressure was markedly lower.

These results are more than suggestive but the series is too small as yet to establish conclusively whether or not these psychological features are generally typical for cases of essential hypertension.




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