Psychosomatic Medicine 12:320-332 (1950)
© 1950 American Psychosomatic Society

Psychosomatic Aspects of Salivary Activity

II. Psychoanalytic Observations Concerning Hypersalivation

¹ Presented before the Chicago Psychoanalytic Society, October 25, 1949.

The influence of psychologic factors on salivary activity has been investigated extensively by reflexologists; however, there are only a few studies employing the psychoanalytic method which deal with this subject. A review of the pertinent literature on hypersalivation revealed that:

Pavlov had shown that in hungry dogs the expectation of being fed leads to copious salivation.

Hypersalivation occurs commonly in the course of normal pregnancy.

Salivary and gastric secretions change, as a rule, in the same direction (i.e., increased gastric secretion is usually accompanied by increased salivary activity).

Deteriorated schizophrenics show an increased secretory rate; whereas early schizophrenics and depressive patients show a normal or decreased rate.

In young children the parotid secretory rates are extremely high and with increasing age, there is a corresponding decrease in rates.

In animals, sexual excitation is accompanied by increased salivation.

Psychoanalytic observations suggest that increased salivation in man may be brought about by an (unconscious) desire to nurse at the breast.

Three case histories are presented. Two are based on psychoanalytic and the third on anamnestic material. One patient had a duodenal ulcer and another had ulcer symptoms. In the two analyzed cases, conflicts centering around an unresolved, orally-fixated attachment to the mother were important; a regressive competition with younger siblings (for the mother) was also of crucial significance in both cases.

The relationship between hypersalivation and gastric hypersecretion is discussed. It is suggested on the basis of both physiologic and psychodynamic considerations that most patients with duodenal ulcers may be expected to exhibit hypersalivation as well. Further clinical studies are necessary to establish (or refute) this assumption. The possibility of a dissociation between salivary and gastric activity is noted. The psychoanalytic observations reported indicate that hypersalivation is stimulated more by the mobilization of oral-sadistic impulses than by oral-receptive (dependent) ones.

Hypersalivation occurs frequently in pregnant women, whereas the incidence of duodenal ulcers in such cases is very low. The nature of the "oral regression" in ulcer patients and in pregnant women is discussed. In the first instance, the regressive intensification of oral-instinctual impulses results from unsuccessful mastery of interpersonal conflicts and is thus interpreted as a pathologic phenomenon. In pregnant women, however, oral regression is the result of primarily internal physiologic changes and is interpreted accordingly as a normal concomitant of pregnancy. This difference in the nature of the oral regression may account for the very low incidence of duodenal ulcers in pregnant women.

The physiologic aspects of hypersalivation are briefly presented. Parasympathetic stimulation causes increased secretory activity. It is suggested that hypersalivation may be interpreted as another example of "regressive innervation," a fundamental neurophysiologic mechanism, described in detail elsewhere.