From Soma To Symbol

American psychoanalysis has made little systematic study of psychosomatics, even though people have always come to psychotherapy with physical complaints that do not respond to medical treatment and even though the failures of symbolic thought that characterize the psychosomatic disorders are not unique to these patients, but underlie other common clinical presentations as well. Analytic neglect has been due in part to an inadequate conceptual framework, and in part to the notorious technical difficulty of analyzing psychosomatic patients. This book aims to redress both of those issues, enabling psychoanalysts to work more productively with psychosomatic patients and others with similar psychodynamics.For many years, theoretical and geographical distance kept the two preeminent schools of psychosomatic thought - the French and the American - evolving in decisively different directions. Recent rapprochement, however, has softened old ideological rigidities, giving rise to a more capacious theory and a resurgence of interest in psychosomatics. This volume first describes the newly evolved psychoanalytic common ground, as well as supporting work in allied fields.In subsequent chapters, analysts of various perspectives detail their work with psychosomatic patients. These case studies offer readers a chance to observe contemporary psychosomatic theory in action, and also the techniques that have evolved with it to manage the clinical difficulties of the work, especially the effects of somatised experience on the analytic process, and the analyst's countertransference fantasies and reactions. In addition, richly detailed discussions suggest how the new theoretical and clinical integration may apply to other patients with impaired symbolizing capacities, greatly extending the book's clinical usefulness.