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LATENT THUMB-SUCKING—A NEW CHIMERICAL SYNDROME MACK LIPKIN, M.D.* Psychoanalytic description of the successive stages of sexual development and consideration of the concept of an association between latent homosexuality and anal fixation suggested that there might be sequelae of latent oral conflicts. Investigation showed many phenomena worth consideration. I have grouped these under the rubric of latent thumbsucking . Latent thumb-sucking is the catchaU term suggested for activities and attitudes which derive directly or indirectly from the repression of the universal need ofinfants to suck. When the satisfaction ofthis need is prevented by the mother, it is to be expected that some fixation at the oral level wiU occur. Such frustration might result from too-early weaning frombreastor bottleandlaterprevention ofthumb-suckingby thevarious finger guards, painting the fingers with bitter substances, slapping the hand or child, or by other evidence of disapproval. It can be surmised that the frustrating parent or parental surrogate is hostüe to the child but offers such excuses as the statement of dentists that thumb-sucking may produce deformities ofthe dental arch. These phenomena are widespread. Indeed, they are present in virtually all people in our culture. They are illustrated by such a variety ofactivities as the smoking ofcigarettes, cigars, and pipes; the chewing of gum, especiaUy bubble gum (which combines chewing, sucking, and the appearance ofa round pink eminence in front ofthe mouth); the use ofloUipops and sugar teats; sucking (and clutching?) at straws; the use oftoothpicks as pacifiers. One may ask whether the singing of mammy (mammae?) songs reflects a yearning ofthis kind. There are many phenomena which canbeconsidered as displacements of the same basic drives. The use ofUp- * Address: 115 East 6ist Street, New York, New York 10021. 96 Mack Lipkin · Latent Thumb-sucking Perspectives in Biology and Medicine · Autumn 1970 sticks—perhaps even nose picking and nose-thumbing—certainly tonguekissing , breast-kissing, and various other weU-known oral sexual practices suggest direct derivation from frustrated thumb-sucking. The derisive Italian gestureofhookingthethumb behindtheupperteeth, thensnapping the finger out ofthe mouth, suggests contempt for persistent infantilism. There are perhaps some less obvious derivatives of the frustration of oral needs. Does the substitution oftalking for sexual activity represent a bizarre defense against the oral erotic drive? Are those who spray saliva as they talk having a symbolic ejaculation? And those who drink until they feel sleepy—are they victims ofthis symptom complex? Other drinking practices deserve scrutiny—the use of straws, drinking from bottles, etc. Are those who prefer to drink beer from a can or a glass rather than a bottle more nearly free oflatent thumb-sucking, or is this an attempt, conscious or unconscious, to hide the conflict? Is the gourmet, as weU as the gourmand, another example ofthis trouble? This briefdiscussion iUustrates the range ofdisorders which may derive from this type oforalfixation. The implications are clear. Chüdren should be aUowed to suck until the drive is satisfied. For those, now grown up, who suffer from the various manifestations oflatent thumb-sucking, the problem is harder. Perhaps pacifiers should be used by adults as weU as chUdren, perhaps for years. For most, nothing wiU suffice except longterm , deeply searching psychotherapy, since these conflicts go back to early infancy. Perhaps the endless talking in psychoanalysis may satisfy some ofthis oral need. Clearly the defenses are deeply rooted. They are not to be vanquished by swaUowing piUs atregular intervals, unlesspermanent unconsciousness is produced. The latter would seem much too heroic a measure for overcoming the commonest manifestation oflatent thumbsucking (tobacco smoking). If deep psychotherapy is not avaüable, the patient will probably continue smoking untü bronchogenic carcinoma or chronic pulmonary emphysema brings to a sad end a difficulty arising in infancy because ofparental ignorance ofelementary psychoanalytic concepts . My personal solution to this problem oflatent thumb-sucking has been the occasional application ofmy tongue to my buccal mucosa. Addendum: This essay was taken seriously by three psychiatrists, one professor and two associate professors ofmedicine, and one professor of pediatrics. Two medical students laughed heartily, bless them. 97 ...

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