THE SYMBOLIC BODY AND THE SYMBOLIC SYMPTOM

The differential analysis of the symbolic expression and of the symbolic symptom enlightens the relation between body, language and symbol. The displacement and condensation, which explain the symptom, involve a bodily perception of a symbolic nature. Consequently, Freud tends to interpret the symbol according to the symptom formation, as opposed to J. Lacan, who equates displacement with metonymy, and condensation with metaphor. The author, in analyzing the similarities and differences, interprets the symptom as a desymbolization, which presupposes a presymbolic perception, which phenomenology has thematized. However, it is language which structures this perception as symbolic, and which introduces the symbolic finality; which the psychological dynamisms do not have by their own selves.     

‘I am not crying. I am rubbing my eyes’: Annie and the hollow object

This article explores the relationship between the development of severe eczema and asthma in an eight-year-old girl and her difficulties with experiencing psychic pain and conflict. The author focuses on the transference dynamics that preceded and surrounded the psychosomatic reaction in the session. The observations in this case may explain why patients, despite feeling taken over by intense physical sensations, can display flatness and superficiality of affect giving the appearance that they are emotionally ‘hollow’. The author proposes that these patients experience an emotional sense of emptiness in themselves and in their objects that is the result of a very early defence of dissociation caused by overwhelming anxieties of annihilation that are lived out in and through the body. The appearance of a psychosomatic symptom during the session can follow the emergence of sudden and intense raw hostile feelings towards the primary object, accompanied by a sense of danger and profound anxiety, as the hated object is also desperately needed for the subject’s own physical/emotional survival. The analyst can contribute to triggering these episodes by failing to contain the patient’s projections, which may lead to the patient feeling forced to re-introject unprocessed and unbearable ‘psycho-physical’ emotions. This article discusses the different degrees – and forms – of symbolic functioning in connection to this girl’s experience of her eczema and asthma and their manifestation in the transference relationship to the therapist.     

Medicine's symbolic reality

Modern socio‐cultural studies of medicine demonstrate the symbolic character of much of medical reality. This symbolic reality can be appreciated as mediating the traditional division of medicine into biophysical and human sciences. Comparative studies of medical systems offer a general model for medicine as a human science. These studies document that medicine, from an historical and cross‐cultural perspective, is constituted as a cultural system in which symbolic meanings take an active part in disease formation, the classification and cognitive management of illness, and in therapy. Medicine's symbolic reality also forms a bridge between cultural and psychophysiological phenomena; the basis for psychosomatic and socioso‐matic pathology and therapy. This in turn becomes a central problem for medical theory and for a philosophical reinvestigation of medicine.     

The moderating effects of gender on the associations between multidimensional hostility and psychosomatic symptoms: a Chinese case

The purpose of this study was to examine the effects of gender on the relationship between multidimensional hostility and psychosomatic symptoms in Chinese culture. The participants in this study were 398 Chinese college students (40% female) recruited from Taiwan. Four dimensions of multidimensional hostility-hostility cognition, hostility affect, expressive hostility behavior, and suppressive hostility behavior-were measured by the Chinese Hostility Inventory. After controlling for the effects of depression and anxiety, the results of path analysis revealed that the multidimensional hostility predicted psychosomatic symptoms directly, and predicted psychosomatic symptoms indirectly through negative health behavior. Furthermore, gender moderated the relationships between multidimensional hostility and health outcomes. Expressive hostility exacerbated psychosomatic symptom in females but buffered it in males, while affective hostility exacerbated psychosomatic symptoms in males. Additionally, suppressive hostility behavior was correlated to psychosomatic symptoms indirectly through negative health behavior in females. Moreover, expressive hostility was correlated to psychosomatic symptoms indirectly through negative health behavior more in males than in females.     

Teresa of Avila: The will and the weaving

For more than forty-five years as a Carmelite nun in the sixteenth century, Teresa of Avila suffered from great physical pain. We see in her life how disciplined prayer can become a healing experience that moves from minimal psychic representation to full symbolic representation. After a brief examination of Teresa's life, two theoretical perspectives on somatic manifestation will be reviewed: the theory of conversion hysteria of the classical Freudian school, and the differentiation Joyce McDougall draws between hysterical and psychosomatic phenomena. For the psychosomatic, as the mystic, the void of wordless space has significance. Following after McDougall on the suffering body, a third perspective will be offered: the concept of conscious body suffering as a means to inner change.     

Bound Together by Chronic Pain and Trauma: A Study of Two Mother–Daughter Relationships

Girls and women are disproportionately affected by chronic pain unrelated to medically defined disease. Because the mother–daughter relationship is pivotal in female development, one can speculate that chronic pain could be entangled with and expressive of the mother–daughter relationship. I describe two women who came for treatment with chronic pain and other psychosomatic manifestations as the primary symptoms. Both experienced profound trauma and had deeply conflicted relationships with their mothers, in which reflective function and symbolic capacity were stunted, resulting in a physical language.     

On being, knowing and having a self

This paper(1) takes the distinction between being conscious ('core consciousness') and knowing that one is conscious (self-reflexive consciousness) as a starting point for differentiating between three different aspects of the self: 1) the overall process of psychosomatic being which we share with all living creatures and which expresses itself through action (self as totality), 2) the conscious awareness of knowing the self that is a peculiarly human phenomenon consequent on the development of symbolic imagination (sense of self including numinous experiences of the self) and 3) having a self (or soul) as an essential attribute of being human that can only be achieved through being endowed with a self in the mind of others (self-identity leading to the self as the centre of the personality). Some clinical implications of these distinctions are considered including the role of interpretation as fostering integration through the provision of alternative self-images, the loss of self-reflexive consciousness in states of overwhelming affect and the attack on the spontaneous psychosomatic being of the self in states of self-hatred and self-division.     

The 'self' in analytical psychology: the function of the 'central archetype' within Fordham's model

This paper concerns the self as Fordham came to conceive it after a conceptual analysis of Jung's use of the term. Fordham identified a contradiction in Jung's usage, and resolved it by reserving 'self' for a definition of the psychosomatic entirety of the individual, and using a separate term for referring to expressions of the self in human experience (e.g. symbols). Fordham tentatively suggested that the latter be termed the 'central archetype', although this was neither developed nor dropped. I explore the value of this term from a developmental perspective and, more specifically in terms of the deintegration of psyche out of an early psychosomatic unity. This draws upon infant research and an observation of a 14-month old boy. Finally, further developments are briefly described and illustrated, whereby pre-symbolic expressions of the central archetype become symbolic and come to reflect what was for Jung, the 'ultimate', 'Formation, Transformation, Eternal Mind's eternal recreation'.     

Die psychosomatische Triangulierung

Zusammenfassung   Das Konzept der psychosomatischen Triangulierung bietet einen entwicklungsorientierten Ansatz für das Verst?ndnis psychosomatischer Symptombildungen. Der Begriff wurde von Peter Kutter eingeführt, stie? jedoch, im Gegensatz zum Konzept der frühen Triangulierung, nicht auf bleibende Resonanz. Geht es in Kutters Modell der psychosomatischen Triangulierung um ein Geschehen im Dreieck zwischen dem Kind, dem K?rper des Kindes und der Mutter, in dem sich das Kind seinen K?rper aneignet und damit einen Schritt der Abl?sung von der Mutter vollzieht, so tritt im Dreieck der frühen Triangulierung der Vater oder ein anderer Dritter von au?en zur Mutter-Kind-Dyade hinzu und erm?glicht Losl?sung und Individuation. Es wird zun?chst gezeigt, dass der Begriff der psychosomatischen Triangulierung zweierlei bezeichnen kann, zum einen als gelungene psychosomatische Triangulierung einen Entwicklungsschritt, zum anderen bei einer misslungenen frühen Triangulierung eine Notl?sung, in der der K?rper an die Stelle des Dritten tritt. Eine Untersuchung der mit der Aneignung des eigenen K?rpers verbundenen Vorg?nge der Affektspiegelung und der Symbolisierung erweitert dann das Konzept der psychosomatischen Triangulierung und erm?glicht eine Verknüpfung mit den therapeutisch relevanten Vorstellungen über Prozesse der semiotischen Regression und Progression. Es zeigt sich, dass unabh?ngig davon, ob der K?rper in der psychosomatischen Symptombildung symbiotisch, übergangsobjekthaft oder symbolisch verwendet wird, die Suche nach M?glichkeiten, eine dyadisch abgeschlossene Konstellation zu einer triadischen zu erweitern, zu semiotischer Progression und Entwicklung führen kann.

---

Psychosomatic triangulation

Abstract   The concept of psychosomatic triangulation provides a developmentally based perspective in order to understand the dynamics of psychosomatic symptoms. Originally introduced by Peter Kutter, this concept lacked – in contrast to that of early triangulation – a long-lasting resonance. Whereas Kutter's model focused on the triangle of child, the child's body and the mother, in which the child gradually acquires its own body and thus undertakes steps towards the separation from the mother, in the process of early triangulation the father, or another significant third person, joins the mother-child dyad and facilitates separation and individuation. First, it will be shown that the concept of psychosomatic triangulation means two things: on the one hand it is a successful psychosomatic triangulation as a developmental step, on the other hand it can also mean a stop gap solution if early triangulation has failed and the body takes the role of a third person. A survey of processes of affect reflection and symbolisation which develop on the way to acquiring the body, widens the concept of psychosomatic triangulation and provides us with a deeper understanding of ideas of regression and progression which are mainly clinically relevant. It will be shown that regardless of whether in psychosomatic symptom formation the body is used in a symbiotic, transitional or symbolic way, the search for possibilities to widen the dyadic constellation into a triadic one can lead to semiotic progression and development.

     

A case of bronchial asthma treated by behaviour therapy

Desensitization employing the reciprocal inhibition principle was applied to a case of intractable bronchial asthma. Therapy has resulted in dramatic and maintained improvement. An explanation, in terms of learning theory, is given on the development of the psychosomatic symptom, and the rationale of the treatment explained. It is suggested that should relapse occur, booster treatments administered on an out-patient basis would be a feasible proposition.     

Personality and Health in the 1980s: Psychosomatic Medicine Revisited?

This special issue is a sign of a resurgence of interest in the role of personality in health not seen since the 1940s and early 1950s when the promises of the psychosomatic approach to health and illness appeared to be the greatest. This new look at personality and health represented by contributions to this special issue attempts to address the limitations of earlier work in psychosomatic medicine by making more explicit efforts to define personality variables precisely, to distinguish these variables from conceptually related psychological constructs, and to embed them in a body of theory and empirical research. This new work also attempts to remedy methodological limitations of earlier work by placing greater emphasis on prospective research and highlighting distinctions between symptom reports, illness behavior, and actual illness. However, the new work and earlier work in psychosomatic medicine share certain working assumptions, for example, a primary emphasis on the relatively direct impact of personality on disease onset, an assumption that personality variables operate in interaction with stressful events, and a frequent emphasis on general susceptibility to disease. Moreover, this new work frequently risks the same methodological pitfalls that limited scientific progress in psychosomatic medicine. We argue that the rapid rise and decline of psychosomatic medicine is most likely to be repeated in research on personality and health in the 1980s if reasonable criteria for considering personality variables a risk factor for disease are not precisely defined, disease endpoints (the dependent variable) are not assessed precisely, personality variables of interest (the independent variable) are not empirically distinguished from other related psychological variables, and complex relationships among risk factors are not taken into account. It is emphasized that models drawn from personality research cannot be transferred unchanged to the health arena without risking false inferences about the role of personality in health.     

SIMONE WEIL'S SPIRITUAL CRITIQUE OF MODERN SCIENCE: AN HISTORICAL‐CRITICAL ASSESSMENT

Simone Weil is widely recognized today as one of the profound religious thinkers of the twentieth century. Yet while her interpretation of natural science is critical to Weil's overall understanding of religious faith, her writings on science have received little attention compared with her more overtly theological writings. The present essay, which builds on Vance Morgan's Weaving the World: Simone Weil on Science, Necessity, and Love (2005), critically examines Weil's interpretation of the history of science. Weil believed that mathematical science, for the ancient Pythagoreans a mystical expression of the love of God, had in the modern period degenerated into a kind of reification of method that confuses the means of representing nature with nature itself. Beginning with classical (Newtonian) science's representation of nature as a machine, and even more so with the subsequent assimilation of symbolic algebra as the principal language of mathematical physics, modern science according to Weil trades genuine insight into the order of the world for symbolic manipulation yielding mere predictive success and technological domination of nature. I show that Weil's expressed desire to revive a Pythagorean scientific approach, inspired by the “mysterious complicity” in nature between brute necessity and love, must be recast in view of the intrinsically symbolic character of modern mathematical science. I argue further that a genuinely mystical attitude toward nature is nascent within symbolic mathematical science itself.     

The relationship of sex-role stereotypy to anger expression and the report of psychosomatic symptoms

The purpose of this investigation was to assess the relationship between selected psychological and behavioral measures concenred with the expression of anger and the report of psychosomatic symptoms. Presumably healthy college students filled out a symptom inventory which served as the criterion measure. Additionally, questionnaires were used to measure sex-role stereotypy, assertiveness, various types of hostility, and hostility guilt, which were then employed in a series of related analyses. Results supporting predicted relationships consistently demonstrated a positive association between the number of symptoms and indirect expression of anger as well as certain stereotypically feminine traits. Significant negative correlations were found between the symptom measure and assertiveness and between the symptom measure and scores on masculinity scales. Predictions that symptom frequency would be negatively related to the direct expression of hostility and positively related to hostility-guilt were not supported.     

Towards an interpersonal understanding of bodily experience

This paper attempts to understand the interpersonal nature of bodily experience. It explores the way the body symptoms we meet in the consulting room, and in everyday life, express and communicate disturbances in our relationships with others. The article seeks to understand how others that are close to us can really get under our skins. The work of the philosopher of the body, MerleauPonty, findings from contemporary developmental psychology, recent psycho-biological studies and psychoanalytic insights are all drawn upon as a way of offering an introduction to contemporary developments in thinking and research on the body.

The article explores the interdependence of body and environment. In particular, the body is always in an interpersonal context with others. Bodies are interdependent; communication is first and foremost bodily. Bodily behaviour and biological functions develop in the context of a relationship. The relationship with the other influences the formation of bodily processes and actions. Clinical examples are drawn upon to illustrate how interpersonal disturbances in development are expressed in bodily symptoms. The difference between a hysterical and psychosomatic body symptom is also briefly addressed.     

SYMBOL AND PSYCHOSOMATIC SYMPTOM IN BODILY SPACE-TIME: THE CASE OF THE YAKA OF ZAIRE

The Northern Yaka see the body as an expanse bounded in time and space. Alimentary traffic, olfactory exchange, and procreation constitute oriented transitions of the body boundaries. They provide a spatiotemporal order (inner-surface-outer, high-middle-low, before-simultaneous-after, etc.) which, by symbolic transference, patterns the semantic integration of the social, natural and bodily domains and which is itself patterned by this integration. The body-self has to do with the body as receptive of, and participating in, the activities of the other: in sensorial interaction, that is, in encounter, exchange, smelling, listening, speaking and seeing, individuals serve as reciprocal points of identification. They pattern, and are patterned by, the relationships between the psychosomatic and the sociocultural, between self and other, ascendant and descendant, male and female, etc. I am concerned with the ways these multidimensional relationships in and through the body acts and the body-self may be symbolic, i.e., when they integrate, by differentiation and mediation in a metaphoro—metonymical process, the bodily, social and natural spheres; these relationships are symptomatic when they are disintegrative, dualistic, or intrusive.     

Transference symptom

Transference symptom is a hazy notion in Freud's writings. The notion is presented here as a particular moment in the crystallization of the transference neurosis. It results from a double cathexis of the analytic frame and the analyst resulting in a symbolic distortion that is represented plastically within the session, as occurs in dreams. The transference symptom proceeds from two different preconscious cathexes, one attached to the reality of the frame, the other to the drive linked to the analyst. A psychic space is thereby opened up for interpreting both the resistance and the unconscious derivatives of infantile conflict. The transference symptom is a compromise formation that includes the analyst and questions the countertransference stance. Three different analytic situations give rise to transference symptoms according to the relative balance between frame and process in the analytic encounter. The concept is compared with enactment.     

Building bridges between body and mind: The analysis of an adolescent with paralyzing chronic pain

This paper describes the evaluation, initial psychotherapy and subsequent psychoanalysis of an adolescent who presented with a severe psychosomatic process involving total body pain and profound fatigue. The author details the complex and multifaceted nature of the psychosomatic process as it unfolded in the treatment. The psychosomatic problem was not a single entity, but rather was comprised of diverse interwoven elements such as somatization, conversion on pre-oedipal and oedipal levels, conflicts over aggression, sexuality, identity, masochism, secondary gain, anaclitic depression, internalized self-other interactions with a depressed mother and transgenerational transmission of trauma. The author uses the case material to discuss technical approaches to problems that often arise in the analytic treatment of patients with complicated chronic pain and fatigue as the primary complaints. Such approaches include respecting the mind-body split as a primary defense, speaking the language of the body along with the language of the mind and developing the verbal sphere around the non-verbal symptoms. The author emphasizes that complicated chronic pain problems are common and can be helped by psychoanalysis as long as the unique and complex features are understood and reflected in the technical approach.     

人格维度、自我和谐及行为抑制与心身症状的关系

研究旨在通过实证研究建立人格维度、自我和谐、行为抑制和心身症状之间关系的结构方程模型。对600余名被试问卷测量的相关、回归和结构方程模型分析表明,人格维度可以直接和/或通过行为抑制和自我和谐对心身症状有着正向或负向的预测作用,而且自我与经验的不和谐、行为抑制和心身症状本身都可以作为心理健康的指标,它们之间又存在密切的相互关系