In this paper I develop my contention that reality is experienced polymorphically at different levels along a concrete-abstract continuum. At the more abstract and psychic level the internal representations of primary reality are, to varying degrees, verbally labelled. However, for various reasons, this verbal symbolisation is rarely adequate or complete—even in adulthood, and hence the persistent recourse to somatisation, acting out, projection and other psychological strategies and defences. This paper also examines, using both constructivist and psychodynamic models, how verbalisation can be helpful in clinical practice with somatoform disorders as both models are concerned with the “talking cure”. Drawing on our understanding of meditation and mindfulness, the role of our psychological defences in limiting our consciousness is examined, in contrast to the practice of non-verbal mindfulness which aims at expanding our awareness. Potential problems with meditation are discussed, as well as limitations to the “talking cure”—as verbalisation can also be used as a higher order defence. However, it is concluded that all awareness expanding practices, such as mindfulness and psychotherapy, reduce the need to resort to somatisation and other primitive awareness distorting strategies. In this paper constructivist (Kellian) and psychodynamic (both Freudian and post-Freudian) perspectives are employed to develop my contention that reality is experienced polymorphically at different levels of cognitive awareness along a concrete-abstract continuum. At a more abstract (or largely psychic) level the internal representations of primary reality become, to varying degrees, verbally labelled as we develop and mature from infancy. However, this verbal symbolisation is rarely sufficient or complete—even in adulthood, and hence the persistent need for somatisation, acting out, acting in, and primitive forms of communication and psychological defence, such as hysterical identification, projective identification and/or other forms of basic communication typically found at the lower levels of awareness. This paper further goes on to examine, especially using constructivist, but also psychodynamic models, how verbal symbolisation can be helpful in practice with psychosomatic and hysterical disorders. Drawing on our understanding of concentrative and mindfulness meditation the workings of our psychological defences are examined. Constructivist and psychodynamic models are used to describe the distortion of consciousness by these defences—albeit from different perspectives. Both of these psychotherapy approaches are also concerned with the issue of increased awareness via insight, and are therefore complementary to the Eastern notion of enhanced awareness through the practice of meditation and mindfulness. Potential problems with meditation are discussed, as well as limitations to the “talking cure”—as verbalisation can also be used as a higher order cognitive defence, as observed in rationalisation—as well as in the higher service of the expansion of awareness.
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