ABSTRACT
Whilst still in his sixties, Attis experienced dizzy spells while playing golf on one occasion, and these occurred again when he was in the kitchen at his home. His decades of experience in investigating his internal world led him to seek a possible psychological cause. He could not come up with a reasonable event initiating his dizzy spells. Then he called me. Attis’ searching for a psychological explanation of his dizzy spells made me recall a mental image from many years before of myself on my analyst’s couch, analysing away a symptom I was having—regurgitation during sleep that would wake me up. My analyst suggested that this might be caused by a hiatal hernia, which proved to be the case. Remembering this, I suggested to Attis that he have a physical examination. He went to see a neurologist who referred him to a cardiologist. Apparently, Attis told this cardiologist that I was his psychiatrist who had urged him to seek a medical cause for his dizzy spells. Later, the cardiologist called me and told me Attis needed a permanent transvenous pacemaker. He had sick sinus syndrome, which causes a spectrum of bradyarrhythmias and, occasionally, bradyarrhythmias following tachycardia. The cardiologist noted that Attis did not want metal in contact with his skin and wondered if there could be a psychological reason for this aversion. When Attis 126consulted with me, we noticed that his fear over his physical condition had stimulated a fear from his childhood. He refused the cardiologist’s advice because the idea of metal contact with his skin represented the axe that had removed his finger. Attis ended up agreeing to a pacemaker if necessary, but when the cardiologist told him that his heart problem would progress slowly and its advance was unpredictable, he decided not to get one and continued a normal physical existence, playing golf, helping teenagers, and occasionally visiting his lover.
