Early traumas in psychosomatic patients: Splitting and integration

Abstract

This presentation was based on clinical experiences with psychosomatic dialogues as these were articulated in psychoanalytic therapy. For Winnicott, a psychosomatic disorder is also a psychosomatic link. It implies the hope that primary psychic processes, the dialogues between psyche and soma, will be resumed. In our cases, the coexistence of repressions and splitting was matched with two psychic currents: the work of unconscious transformations, and the repetition compulsions of traumas. We focused on splitting and integration processes in cases of preverbal early traumas, using the clinical thinking of Winnicott. The psychoanalyst is prepared to wait respecting the splitting as long as it is necessary for the synthesizing function of the ego to resume the processes of integration. The psychoanalyst assumes a function that resembles mother's ‘primary maternal preoccupation’. This approach is based on the hypothesis that psychic processes begin with the imaginative elaboration of body sensations, excitations, and functions: it transforms them into images, it renders them suitable for psychic life. It is the psychic economy of the object that intervenes in the management of body-drive excitations.