title: A concept of analytical treatment for patients with psychosomatic disorders. Report on the psychosomatic phenomenon and its consequence for therapy.
abstract: With the Paris school the author holds the view that the 'pensée opératoire' is pathognomic for the psychosomatic patient. This archaic, 'automatistisch-mechanistisch' thinking is a consequence of defects in the sphere of the physiological pre-ego. Certain typical findings, such as reduplication and mechanized object relations are seen as correlates of disturbances in the patient's early identification processes. Analytical therapy must thus aim at shifting the all but inaccessible psychosomatic phenomenon into a historical perspective. The psychological event can set in only when the patient has discovered the connexion between his somatic reaction patterns and the emotions he is beginning to feel for the security-giving therapist. An account of the development of the treatment of one patient (Birgit) illustrates the author's concept of analytical therapy in psychosomatics. The 'facilitating environment' helped the patient Birgit to differentiate herself from her dual object and thus to be able to cathect the level of the triangular relationship. The concept of the model ward led on to the development of an ambulatory method of therapy, 'relaxation analytique', which is based on investigations into the concept of the holding function. 'Taking care' of the patient is function of the therapist's own inner attitude, of his being prepared to do everything to encourage the therapeutic regression. The correlate of this attitude, on the side of the patient, is the sense of security which is an essential condition for the 'new beginning' to set in.
mesh_terms: D000328:Adult; D001290:Attitude; D003379:Countertransference; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D011575:Psychoanalytic Therapy; D011602:Psychophysiologic Disorders / Q000628:therapy*; D012649:Self Concept