ABSTRACT
In Chapter 10, four male patients with severe personality disturbance are described in whom surgery on their genital or perineal areas was followed or preceded by increased psychiatric symptomatology. What renders these men susceptible to psychiatric complications to surgery is explored. In the case where adequate historical detail was available, a psychodynamic formulation is undertaken, including the unconscious meaning of surgery to the patient. The propensity of these individuals to alternate between idealizing and devaluing their physicians is described. Suggestions on identifying and managing such patients are offered.
