> The theme could be indicative of a phobic response to getting
> pregnant. Water is a symbol for motherhood in so far as water
> provides life. The expressed symptomatology covers the reproductive
> system in so far as 'pelvic organs were different'. Clearly, I
> don't think it would be a stretch to assert that these women are
> likely to be of child bearing age and may in fact share in a
> phobia of becoming pregnant and giving birth. The delusion that
> they could not urinate might mean that they fear that they will be
> unable to endure the process of birthing.
 
> these clients hold towards pregnancy. Please let me know if any of
> these women are not of child bearing age?
>
Thank you very much for your comments. On reviewing my notes, I find
that the majority of patients are older than 35, about five are past
child-bearing age, and many have children. Thus, the "demographics" seem
 similar to that seen in psychotic depression in general. However, your comments
 seem to me of particular relevance in one patient. She fell ill
immediately after childbirth 33 years ago and had to be hospitalized
for months. A main theme in her delusion was that the tubes in the
hospital walls would burst and drown everyone. After that episode,
she was fine for 31 years, until her daughter (the child she had born
prior to her first illness) herself became pregnant. She was
convinced that her daughter would die under labour, and urged her to
abort the child. When the daughter refused, the patient attempted
suicide - of interest in the context of the present discussion, by
trying to drown herself in the local river, a pretty rare method
where I work since you can't really do that in there since the water
is too shallow. In her psychosis, this patient refused to urinate to
the point where a catheter had to be inserted. Flooding and drowning
were again prominent in her thoughts.
Kind regards, Andreas
                    ___..---'---`---..___
                 .-=========================-
 _______________/ :.::..-~--..___..---~~~
(___________(_||_)____/ Dr. Andreas Meyer-Lindenberg
 /____/___:..::.:::. / Zentrum fuer Psychiatrie
         \_________/  Am Steg 22, 35385 Giessen, Germany
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