Referring to a succestul prolonged psychotherapy of a patient who suffered from a recurring self-mutilation of the eyes, we discussed several pathogenetic and psychodynamic factors of the syndrome of idiopathic automutilation.
These patients are suffering unbearable libidinal-agressive tensions, which are discharged in automutilative actions without suicidal intentions. It appears that these actions should be interpreted as a combination of masturbation-equivalents with masochism, self-punishment, concealed ,negalomanic fantasies and autocastration, along with retaliation, infantile struggle for power, a longing for protection and the wish to escape the demand of grownup communication and sexuality. This syndrome is mostly seen in young inhibited women who are fixated in the oedipal and pre-oedipal phase and who are brought up in rigid cold orthodox-religious environments. A want of emotional warmth and specially a lack of skincontact in early childhood appear to be of importante.
Finally we discussed the 'Münchhausen' syndrome which is related to the recurring self-mutilation syndrome.