Pathological primary identifications and their effects on the psychosomatic economy of the individual.

Abstract

The paper deals with the problem of the unstable psychosomatic economy and the patient's consequent susceptibility to psychosomatic disturbances. This goes back to a primary psychobiological defect in the sphere of his earliest identifications, which comes to the surface in emotional crisis situations. The term "Psychosomatic Phenomenon' is used to describe this basic disturbance in the patient's relationships, which can be observed in his interactions with the psychotherapist or interviewer, where it takes the form of a noticeable lack of fantasy, poor relationships and a reduced capacity for psychic experience and elaboration. The author's object-psychological approach has grown out of years of experience in the analytical treatment of hospitalized psychosomatic patients. A 'toxic environment' can be seen to have been a disturbing influence on the early development of the infant. A child whose mother herself knows no autonomy cannot develop its own fantasies through autoerotic activity and thus cannot build up a libidinal object in its inner world. The result is that such an individual is incapable of meeting the inevitable somatic disorganizations with differentiated reorganization processes and so has no defense against physical illness.