History of Psychiatry

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Bulgarian psychiatry: development, ideas, achievements

Kiril Kirov, George Kirov and A.W. Beveridge
History of Psychiatry 1993; 4; 565
DOI: 10.1177/0957154X9300401607
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565-

Bulgarian psychiatry: development, ideas,

achievements
KIRIL KIROV*
Translated and edited by
GEORGE KIROV

Edited by
A. W. BEVERIDGE

Developments prior to the Second World War

The development of Bulgarian psychiatry has been fundamentally influenced
by events in its countrys history. During the Middle Ages Bulgaria was a
well organized and at times powerful state. However, towards the end of the
fourteenth century it was enslaved by the Ottoman Turks and remained
under their rule for almost five centuries. This enslavement, which involved
all the Balkan states, severed the country from the rest of renaissance Europe
and slowed down every aspect of its development. During the seventeenth
century there was even a danger that the nation would disappear. After the
Liberation of 1878 the country began a rapid revival which was only
interrupted by political upheavals and the heavy defeat of the First World
War.
Information concerning the care of psychiatric patients before the
Liberation is sparse. During the Turkish domination the mentally ill were
isolated in monasteries. Specialized psychiatric hospitals only emerged
towards the end of the nineteenth century. Until very recently there was a
scarcity of places and the accommodation, often old prisons or monasteries,
was unsatisfactory. However, the general cultural backwardness did not
unduly hinder the work of individual doctors. For example, Danadjiev
(1866-1943) wrote several monographs, mainly on forensic problems.
Vladoff published a book in France about murders in mental pathology
(LHomicide en pathologie mentale), which was awarded a prize by the French
Academy of Medicine.
*

Address for correspondence: Dr

Denmark Hill, London SE5 8AF.

George Kirov, Genetics Section, Institute of Psychiatry,

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566

The first Chair of Psychiatry was established by Popov, a Russian

emigrant, in 1922 as part of the recently-created Medical Faculty in Sofia.
Krestnikoff (1880-1936) became the first Bulgarian to hold the chair.
Influenced by Hughlings Jackson, he wrote a paper on the principles of
dissociation2 and developed his own psychotherapeutic method spontaneous reproduction. This was a version of catharsis, a technique
which is still practised in the country today.
An eminent clinician who became recognized in Europe (mainly among
German-speaking psychiatrists) was Nikola Schipkovensky
(1907-1976).
One of his early works, Schizophrenia and Murder,33 was published in
Germany in 1938. In this work, which is still cited, Schipkovensky studied
the case records of Munichs Psychiatric Clinic and classified the different
kinds of murder. The first group was the delusionally-motivated murder
which was further divided into two types: the self-defensive and the
sacrificing. The self-defensive type was held to be quite common and was
said to be the result of psychotic anxiety and ideas of persecution. The
sacrificing type was infrequent and often motivated by grandiose ideas such
as saving the world by sacrificing another person, often a member of the
family. As will be discussed later, Kirov connected this sort of murder with
the anxiety-happiness psychosis of Wernicke-Kleist-Leonhard, and more
precisely with its ecstasy phase. Other psychotic murders according to
Schipkovensky were (a) parabulic, i.e. influenced by automatisms
(Clerambault), (b) the impulsive and (c) the catatonic. Another group of
murders was the interferential, which were those influenced by a mixture of
psychotic and normal psychological experiences. Another group was made
up of the understandable cases where psychosis did not play any part. To
the types of murder already known in the literature (indirect, extended,
merciful and raptus), he added several more: (a) tanatophobic, (b) mitigation
of family wrongs and (c) paranoid. He maintained that schizophrenic and
melancholic murders had certain pathognomonic features and he presented
further support for the division of the endogenous psychoses. In later years
Schipkovensky studied suicide in cases of melancholia and concluded that it
originated in morbid feelings of guilt. He showed that melancholic patients
killed more frequently than people with epilepsy or schizophrenia.
Schipkovensky analysed other mentally ill murderers. His studies of
epileptic patients who showed epileptoid personality changes but who were
not psychotic differentiated the following groups. The most frequent were
the avenging and liberating types of murder; the latter was committed in
order to be liberated from someone (e.g., a mother gets rid of her newborn
child). Other types were due to envy or jealousy (e.g., poking out the eyes of
fellow-patients). With regard to the mentally handicapped he suggested
another classification of murders: (a) cannibalistic, (b) avenging,
(c) influenced by others, (d) Cains, (e) displaced (Ersatzmord), (f) liberating
and (g) those relating to attacks on civil servants during their duties.44

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567

Another of

contributions was his monograph

work
which discussed iatrogeny in
extensive
iatrogeny.5
literature (i.e. Montaigne, Moliere, Tolstoy, Chekhov etc.), its causes, its
place in various clinical specialities and the influence of education. Its
importance was shown by its translation in the GDR, USA and Japan.
Another influential clinician, Georgi Usunov (1904-1971) contributed
both to the development of Bulgarian psychiatry after the Second World War,
and also to the Faculty at Sofia University. His main scientific contributions
were in the field of exogenous psychoses, but he also wrote about atebrin,6
bromide, phenobarbital, alcoholic encephalopathies and exogenous psychoses
in children. Usunov supported the idea of the relative specificity of the
clinical picture of exogenous psychoses. In this respect he anticipated the
later teaching of Wieck and others, which widened Bonhoeffers concept.
Usunov also pursued experimental work on drugs-provoked seizures, and
together with Bozhinov and Georgiev he made an extensive study of
subacute sclerosing leucoencephalitis.

Schipkovenskys important
This

on

was an

Development after the Second World War

In the first years of the totalitarian regime in Bulgaria several new medical
faculties were created. The first was in Plovdiv, and others followed in Varna
and Pleven. The chair of Psychiatry in Plovdiv was held by Cholakov who
wrote many original monographs on neuroses, psychoanalysis, schizophrenia
and psychopathology. The chair in Varna was held by Ivanov, who was a
follower of Pavlov and worked on sleep therapy, schizophrenic delusions and
other theoretical problems. His main contribution was in clinical psychology
where he developed several original tests. He also produced work on
psychosomatic medicine, the unconscious, paranoia and the relationship
between philosophy and psychiatry.
Cholakovs successor in Plovdiv was Tashev, whose main work was on
statistical and psychopathological aspects of depression. In particular he
studied heredity, somatyping, suicide and the different phases in depression.
One of his most interesting contributions concerned the so-called paradoxes
in depression. For example, a patient might declare himself incapable of
feeling while he is actually suffering intensely. He might be a virtuous person
but see himself as sinful. He may desire death but at the same time be afraid
of many real and imagined diseases which could lead to his death. No matter
how insignificant and unworthy he considers himself, he nevertheless still
looks for compassion and love. Although deeply depressed, the patient can
be aggressive and kill his own children. In some rare instances, despite his
knowledge of the inevitability of death, he builds a delusional conviction that
he will never be able to die (Achasphers delusion according to

Schipkovensky) .
In the

early days of the totalitarian regime, Bulgaria

was

subjected

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to

the

568

malign influence of the Soviet biologist Lissenko who tried to reject genetic
theory. In these circumstances, which are probably difficult for foreign
scientists to appreciate, many lecturers did not dare to express important
facts concerning heritability in mental illness. It is thus fitting to mention
Milev who tried to demonstrate the endogenous basis of many exogenous
psychoses. For many years Milev studied the genetics of schizophrenia and
he made several important contributions; in particular his ideas about the
genetic heterogeneity of the different types of course of schizophrenia, the
rarity of the disorder among gypsies (quite numerous in Bulgaria) and the
differences in the illness between men and women.
Zaimov, who briefly held the chair in the Department of Sofia, discussed
the similarities between the disorganized thinking in schizophrenia and in the
aphasias. His ideas can be summarized thus: (1) In comparing the
disintegration of the associative process in semantic jargon and in
schizophrenia, it is possible to find phenomenologically similar, even familiar
elements. Such elements include the associative deviations based on meaning
and phonetic relationships, as first described by Kraepelin. To these may be
added associative deviations with intrusions of dominant personality
attitudes, deviations of perseveration, deviations of loss of control or passive
attention, etc. These are called disintegrative deviations of the associative
process. (2) The slips of the tongue of healthy people can be used as a model
for studying these phenomena. (3) In a pathophysiological framework,
deviations in the associative flow in schizophrenia and in semantic jargon can
be interpreted on the basis of Jacksons concept of dissolution, Vvedenskys
doctrine of parabiosis, Pavlovs doctrine of phase states, and Uchtomskys
8
concept of dominance.8
Like his mentors Usunov and Schipkovensky, Zaimov was an excellent
teacher and physician who showed a deep clinical understanding of the
psychoses. Among the works of Zaimov and his colleagues, mention should
also be made of the eminent Bulgarian painter, Bojadzhiev.9 He suffered a
stroke which caused a right hemiplegia and a mixed, mainly motor, aphasia.
The painter subsequently learned to draw with his left hand, but more
importantly there were changes in his style. He now preferred light colours
with an abundance of fantastic elements, and he had a frenetic desire to
paint. These new features could be interpreted either as a complicated
personality reaction, or as the influence of aphasia on artistic style. Together
with Uzunov, Zaimov described one extraordinary paraphrenic patient who
developed a whole writing system by using signs similar to pictograms,
ideograms, syllables and letters.&dquo; It corresponded to the four main phases in
the development of human writing. His alphabet was also enriched by the
spatial orientation of the signs.
Temkov rapidly assimiliated psychopharmacology and together with Kirov
1
published a comprehensive volume&dquo; on the subject. Its value was
demonstrated by its almost simultaneous translation into Russian and it

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569
became the main reference book for Russian psychiatrists for some time
before they published their own work.
A special place in Bulgarian psychiatry is occupied by Dimitrov, whose
work was accomplished during a period when negative and critical attitudes
towards in-depth psychology and dynamic psychiatry prevailed. At that time
any analytical work was considered a serious ideological mistake and
submitting to Western influence. Although Dimitrov lost his sight at the
onset of his medical career, he managed to publish four monographs in
which he concisely presented the teachings of Freud, Adler, Jung, NeoFreudianism and the philosophical basis of psychoanalysis. His studies on the
forerunners of psychoanalysis such as Schopenhauer, Oswald, Wagner and
Feuerbach are particularly valuable and were published in Germany.2, 3
These works were only allowed to be published during the totalitarian era
after the inclusion of critical remarks in the Marxist style.
It is only in the last three decades that creative developments in Bulgarian
child psychiatry have taken place. In 1984 Achkova published a monograph
on childhood schizophrenia, 14 in which she described 70 children followed
up for between 1 and 20 years. She described three symptoms: (a) fading
intention, (b) regressive questions (asking a series of questions and neither
expecting, nor demanding, nor listening to an answer, and (c) impulsive
running away, claimed to be caused by the release of the drive to migrate
which had lost its biological purpose. She maintained that in childhood there
were only the rudiments of symptoms and that delusional mood did not
crystallize into delusions. By following up patients with early childhood
autism Achkova demonstrated that many either developed schizophrenia or
had evidence of an organic cause. She stressed the frequency of catatonic
features, which brought childhood schizophrenia nearer to secondary or
defect catatonia. Together with Christozov she studied affective illnesses in
childhood and pointed out their atypical presentation and their potential for
chronicity. Christozov, who also worked in the field of child psychiatry,
contributed mainly to the area of neuroses.
In the field of diagnosis there are two opposing views in Bulgaria. In some
hospitals the diagnosis of schizophrenia is used quite widely. In others, such
as the University Clinic of Psychiatry in Sofia, there is an unconcealed
attempt to restrict the boundaries of schizophrenia while expanding those of
affective and schizoaffective psychoses.
Schizoaffective psychoses were studied thoroughly by Kirov who used
Leonhards term, cycloid psychoses. By following up the long-term course
of several hundred schizophrenic patients he tried to show that a large
number of acute and recurrent cases were more closely associated with the
affective psychoses and that Leonhard was right to group them as cycloid
psychoses.&dquo; Kirov stated that a number of these cases would not benefit
from depot treatment which only produced side effects without greatly
influencing the course of the disease. Kirov maintained that schizophasia

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570

specific syndrome and described three

study of 44 patients with schizophasia
unspecific initial phase progressed into

stages in its natural

he showed that the
varied and
the highly specific
syndrome of the final stage after an average of 13 years. He also attempted to
show that the disappearance of the ability to feel boredom was very
suggestive of the defect state in schizophrenia.
This last point echoes the work of Popov who described the syndrome of
frozen time. 17 He found that people suffering from paranoid schizophrenia
had several temporal deformations. They ignored the external, socially
accepted indicators of time. Their disorientation for the present led to their
disorientation for the passage of time. They gave more inaccurate and wilder
estimates of the length of passing time. It was only schizophrenic patients
who described artificial and made time, as well as its irregular and
saltatory flow. They also had the experience of the simultanteously fast and
slow flow of time, as well as an inability to distinguish between the past,
present and future, which they tended to fuse together. Events were not
located distinctly in time and were characterized by a certain vagueness
about their length.
Marinov completed the first longitudinal study of schizophrenia in
Bulgaria.&dquo; He followed up 280 patients for an average of 20.2 years. He
found that there were changes in the late stages of the illness, thus
questioning Bleulers observation of stability after five years. The malignant
course (the schizophrenic catastrophe of Mauz) was found in only 1.7% of
patients, and in 17% there was a single epidose without any further illness.
He also found that permanent hospitalization was mainly on social grounds
and that the ratio between the continuous and remittent course was 1:2.
Until recently, research on personality was rare. An exception is the work
of Todorov on anancastic personality.&dquo; He studied 130 people and found
two main components to personality. One was characterized by anxiety and
lack of self-confidence and the other by rigidity and perfectionism.
The most frequent type of addiction in Bulgaria is alcoholism, whereas the
other kinds found in Western countries are relatively uncommon.
Of the many works on alcoholism that of Lazarov is outstanding. He
studied 325 patients with alcoholic psychoses. This condition is on the
increase, and a fifth of registered alcoholics have suffered alcoholic psychosis.
An important finding is that the more these psychoses relapse, the more
commonly are endogenous factors found. Also the earlier they start, the
larger is the role of endogenous factors. Lazarov demonstrated that delirium
84% of alcoholic psychoses and that auditory
tremens made up
hallucinations were much commoner than traditionally accepted.

represented
course.6 In

Therapeutic practices
ECT

was

introduced in 1942 in the

University Clinic

in Sofia and is still

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571

used

widely. Unlike many countries where its use has been restricted (e.g.,
Germany and the USSR), it is considered to be irreplaceable. Its results are
superior to psychopharmacological treatment in many depressions and
especially beneficial in malignant catatonia. In psychogeriatrics ECT is more
effective than antidepressants with the possible exception of Clomipramine.
The views of the University Clinic in Sofia with regard to ECT concurred
with those of The Royal College of Psychiatrists, as outlined in their
Memorandum of 1977.
As might be expected, most patients are treated with psychopharmacological drugs. The most widely used neuroleptics are Chlorpromazine,

Levomepromazine, Thioproperazine, Haloperidol, Penfluridol, Fluspirilene,

Clozapine (used also as an antidepressant) and the depot Flupenthixol and
Fluphenazine decanoate. The most widely used antidepressants are
Amitriptyline and Clomipramine. The main problems arise from the
insufficient and sometimes total lack of new medicines imported from
abroad.
Lithium prophylaxis was introduced in the 1960s by Zaimov. It is widely
used for many conditions including cycloid psychoses. The best results are in
recurrent depressive illnesses followed by schizoaffective illness. Prophylaxis
with Carbamazepine is gathering pace as a result of the work of Milanova.
The last two decades have seen an increased interest in psychotherapy. It
used to be rather primitive, mainly due to the negative attitude of the ruling
ideology. Despite this, Atanassov practised cathartic techniques such as
spontaneous reproduction, which had been introduced by Krestnikoff.2o
Atanassov held that the success of abreactions depended on their intensity
and not on the sequence in which they were performed. He also stated that
the recall of past events was accompanied by vegetative changes in breathing,
blood pressure, pulse rate and sweating. In the new psychotherapy clinics
physicians use a variety of methods but particularly relaxation techniques,
such as the autogenous training of J-H. Schultz.

Transcultural issues

Bulgarian psychiatrists have also contributed to the field of transcultural

psychiatry, for example, Petrovs study of the Pentecostalists. This sect
originated in evangelical Christian communities and practises speaking in
tongues. Glossolalia means talking in foreign or in incomprehensible
language which neither the speaker nor the listener can understand. Petrov
conducted his study together with Sharankov in a village in Northern
Bulgaria in May 1934. He concluded that the Pentecostalists were people
with acute sensitivity and with sentimental personalities who, amid conflicts
with the difficult conditions in life, seek to compensate for its shortcomings
with the help of images which come from the realm of the unconscious and
unfulfilled desires. He found features of infantilism but hardly any elements

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572

of ecstasy. He even suggested that there were elements of partly conscious

simulation.
Further important research in transcultural psychiatry was conducted by
Scharankov (b.1903). He studied an ancient custom which was introduced to
Bulgaria from Greece. This was the nestinarstvo: dancing barefooted on the
charcoals of a big fire.21 The custom took place on the day of Saints
Konstantin and Elena (21 May) but now it has almost died out except as a
tourist attraction on the Black Sea coast. The custom existed in the Strandja
mountains near the border with Turkey, which until recently was remote and
isolated. The dancing was accompanied by the sounds of a pipe and a drum.
The dancers, male and female, sank into a trance-like state, danced around
the fire and passed through it in a few seconds. They did not get burnt or feel
any pain. Scharankov considered the nestinars as persons with morbid
mental experiences and a histrionic-fantastic-eidetic nature (p.215). During
the ritual they achieved a state of depersonalization and derealization. In this
state they found a new, higher meaning of life compared to their usual grey
existence. Sharankov found many other similarities with the sect of the
Pentecostalists.
The greatest contribution in the field of transcultural psychiatry at an
international level has been from Assen Jablensky. He played a leading role in
the gathering and analysis of data for the International Study on
Schizophrenia organized by the WHO. This study showed that the
similarities in the clinical manifestations of schizophrenia among different
cultures were far greater than the differences and that the nuclear syndrome
of schizophrenia had almost the same frequency in geographic, demographic
and culturally distinct populations. Jablensky demonstrated that in no
country was a syndrome described which was unique to that culture. This
fact underlined the consistent nature of schizophrenia across cultures. The
study also led Jablensky to suggest that the idea of specific nosological
entities in endogenous psychoses should be replaced by the concept of a
nosological continuum.
Together with Milev, Kirov studied the spectrum of depressive symptomatology in Bulgarians.22 They found that when Bulgarians had delusions of
guilt, they felt guilty mainly with regard to their family and very rarely with
regard to God. This observation can be explained by the relatively restricted
role that religion assumes in Bulgaria. Some patients felt guilty in relation to
the Communist Party, which had adopted the guise of supreme moral
authority. This study also showed that the painful inability to feel emotions
(anaesthesia dolorosa psychica) was found almost exclusively in women.
Hadzhieva published an article on hashish-induced psychoses in Morocco.
She found that the clinical picture bore more similarity to schizoaffective
disorders than to nuclear schizophrenia. As for schizophrenics who used
hashish, this did not lead to any changes in the nature of their illness. She
also studied the incidence of toxoplasmosis in mentally ill patients and found

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573
amentive

catatonias, hallucinatory, delusional and dementing syndromes. A

peculiarity of the visual hallucinations was their fragmentary and amputated
nature. Psychoses were rarer, but mental handicap was common.
The greatest contribution in the field of epidemiology has been made by
Milenkov. In a study of the incidence of affective psychoses throughout the
country he found an incidence of 2.15 per 10,000 and prevalence of 1.8 per
1000 above the age of 15 years.23 He found that only one in 10 cases of
bipolar illness showed bipolar features during the first episode whereas the
rest were either manic or depressive. Symptom-free remissions did not occur
after the third episode in half the patients and in one out of every 14 patients
after the first episode. The residual symptoms consisted of neurotic,
dysthymic-hypochondriac, hyperthymic-explosive and emotionally labile
syndromes. Contrary to the traditional view there was high morbidity in a
quarter of the patients. The diagnosis of involutionary melancholia was
found to be quite unstable. Finally of 616 patients with affective illness there
were seven

with colour blindness.

Politics and

psychiatry

It is well known that for four and a half decades Bulgaria was ruled by a
totalitarian regime in which one party identified itself with the state and
anybody who did not think and act in accordance with the leaders of the
party were considered to be real or potential enemies. Furthermore, their
opinions could not be discussed in public. A person who has spent his life in
a democratic society cannot imagine the degree to which the state party
interfered with all aspects of life and with an individuals free will. Only in
this light can one understand the rejection and prohibition of reactionarybourgeois theories in science, such as the genetic theory. In the field of
psychiatry the regime tried to impose Pavlovian theory and to stress the
superiority of Soviet science. This explains the incident at the Congress in
Honolulu 1983 in which the Soviet Union was expelled from the World
Psychiatric Association. Immediately afterwards, the leaders of the
Psychiatric Associations of Bulgaria and the other socialist countries except
the former GDR left the WPA in protest. Predictably, the majority of its
members were not even asked for their views, which were far from
concurring with those of the communist-ruled leaderships. We were glad to
be readmitted to the WPA at the Congress in Athens 1989. The recent
political changes in Eastern Europe led to a halt in the politicizing of science
and facilitated contacts with the West.
Finally, there is a highly creditable aspect to Bulgarian psychiatry. It has
not been used as a way of dealing with political dissidents by labelling them
as mentally ill and admitting them to psychiatric hospitals for compulsory
treatment, such as happened in the Soviet Union.

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574

Organization of psychiatric services

With regard to the organization of the health services, it is worth mentioning
the system of local dispensary services for the mentally ill. Every district has
such a service which includes clinics for General Psychiatry but also for
Child and Forensic Psychiatry and Psychogeriatrics. Their main goal is the
active care of the mentally ill, social support and the implementation of longterm treatment. They help the patients who have no carers. Some of these
units are in fact departments of regional hospitals and this facilitates the link
with General Medicine. There are three dispensaries in Sofia and one in each
of the districts. They keep a register of everybody who has suffered from a
psychotic illness, provided they do not refuse to be registered. The patients
are followed up, given long-term medication, their social problems are
tackled and at some centres they are engaged in psychotherapeutic group
treatments or sheltered work places.
Unfortunately, most of our hospitals are not equipped to modem
standards. An exception is the hospital in Vama, built as a result of the
efforts of Ivanov. Another exception is the hospital in Radnevo which was
built from scratch by Dr Kissiov. He managed to build a magnificent park
and sports ground and laid the foundations of a therapeutic community and
group and work therapy centres.
Every medical school has its own extracurricular class run on a voluntary
basis where students gain a deeper understanding of psychiatry and are
engaged in research supervised by experienced assistants. Most future
specialists partake in these classes.
Bulgarian psychiatrists have a scientific society with regional subdivisions
which have their regular meetings. An international congress is held every
five years. The last Congress held in November 1991 saw a heated debate
about changes in the structure and functions of the scientific society. Due to
the variety of views expressed it will take some time before the changes are
implemented but it was clear that the new society will be organized on very
democratic principles with a particular emphasis on teaching.
In this paper the most important ideas and works of Bulgarian
psychiatrists have been discussed. The majority of this work is published
mainly in Bulgarian and so remains inaccessible to other psychiatrists. One
reason for this is that during the totalitarian era the publication of our works
abroad was severely hampered by bureaucracy and censoring to an extent
that the Western scientist would find difficult to believe. Fortunately this is
no longer the case.
REFERENCES
D.
2. N.

1.

Vladoff, LHomacide en pathologie mentale (Paris: Malone, 1911). [Fr]

Krestnikoff, Die heilende Wirkung künstlich herforgerufener Reproduktionen

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1993 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.

von

575
pathogenen affectiven Erlebnissen, Archiv für Psychiatne und Nervenkrankheiten, lxxxviii (1929),
370-410.
3. Nicola Schipkovensky, Schizophrenie und Mord (Berlin: Springer, 1938). [Ger]
4. Nicola Schipkovensky, Schwachsinn und Verbrechen (Jena: Fischer, 1962). [Ger]
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Todor Tashev, Manic-Depressive Illness (Sofia, 1979) [Bulg] .
K. Zaimov, Associative process in semantic jargon and in schizophrenic language. In J.W.
Brown, Jargonaphasia (New York: Academic Press, 1981), 151-168.
K. Zaimov, D. Kitov, N. Kolev et al., Aphasie chez un peintre, LEncéphale, lvii (1969),
377-417. [Fr]
G. Usunov, K. Zaimov, Les Ecrits dun paraphrène, Annales Médico-Psychologiques, cxxx
(1972), 327-356. [Fr]
I. Temkov, K. Kirov, Clinical Psychopharmacology, 2nd Edn (Sofia: Medicina i Fiscultura,
1976). [Bul]
C. Dimitrov, Richard Wagner und Sigmund Freud, Zeitschnft für Psychosomatische Medizin
und Psychoanalyse, xviii (1972), 286-296.
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