ABSTRACT
Starting almost exactly twenty-six years ago, I treated a patient with severe ulcerative colitis for three years in full psychoanalysis. I kept very detailed notes and wrote up virtually every session; this was one of the ways in which I handled psychopathology, which was quite new to me (and I still do, on occasion). I became extremely interested in psychosomatic illness, of which ulcerative colitis is one of the "Big Seven". 1 Obviously I must have thought I might write about that patient sometime, because in 1969, towards the end of the three years, I asked the Royal Society of Medicine, of which I was then a member, to prepare a bibliographical list for me. An outstanding feature of this list today is what is not on it, and how short it is. As a result of combing the American and the British literature, the librarian produced only 31 references to ulcerative colitis, and that included three separate papers by Engel (e.g. 1954, 1967) and three by Melitta Sperling (e.g. 1957). There were no hypotheses either of ulcerative colitis or of psychosomatic illness 92over-all; the general interest that has produced extensive work on psychosomatic illness is a product of the last twenty years.
