[Psychodynamics of psychogenic somnolence (secondary narcolepsy). Case report].
The therapy of a patient suffering from secondary narcolepsy is described. The illness and the function of the symptom as a defense-mechanism are analysed. Sleep appears to be an ontogenetically archaic reaction to extreme--real and neurotic--dangers, which there is not possibility to escape from. The defense against extreme dangers is the withdrawal of all object-cathexis; following Freuds explanations this means: Sleep. In the patient the danger consisted of a regression to a narcisstic position: The symptom helped to avoid a separation of instincts in form of on the one hand narcisstic rage, on the other hand symbiosis. Taking into account the ideas of Spitz, the concept of fusion and separation of instincts is discussed.20