For the philosophical reflection , to see the Problem body-spirit. The psychosomatic term indicates a relation of the Esprit to the body, a mental health disorder which can reflect itself on physical health.

Discovered psychosomatism

It is in second half of the 19th century that the psychosomatic term was born. One allots his paternity to the German Psychiatre Heinroth (1773 - 1843). This new medical current aimed at introducing into the current organicist and experimental of the medicine of the 19th century of the factors of a psychic nature to give an account of causality and the étiopathogénie of certain diseases. This new and global solution of the sick man continued until our days in practice medical and one of its currents constitutes some. Its activity however ran up against the development of discovered and the biological designs which organize the bases of Western medicine today.

Various approaches

Hysteria freudienne

The hysterical Conversion and the disease or the psychosomatic symptom are distinguished. Hysterical conversion is indeed translation of a desire driven back in the somatic one: expression through the body, in a manner symbolic system. The hysterical symptoms often touch with the bodies of the communication: gorges, members…

As well on the level its history as its personality, the psychosomatic patient differs from the hysterical patient: if the symptom or the disease which justifies its complaint is given psychiquement, it is not less real: contrary to the hysterical symptom.

Certain authors moreover agree not to find any symbolic system in the psychosomatic symptoms, supposing an etiology much more antiquated than that of hysteria, and leaving the psychosomatic one the field of the neuroses and the symbolic system: the mode to be of these patients is described as operational Pensée.

Contribution of Groddeck

The psychoanalyst Georg Groddeck is at the origin of the “that”. Its representation of the Esprit in is very impressed. For Groddeck, any disease, and more largely any physical symptom, come from a psychical conflict.

Psychosomatic states

Joyce McDougall opposes Névrose and Psychose on the one hand, and psychosomatic on the other hand. In the neurosis and the psychosis, the conflict is psychic. It can relate to the internal life or reality, but there is a drama which is played in the imaginary scene. The psychosomatic one is, on the contrary, theater of the body.

This analysis includes/understands the psychosomatic one like consequence of a refusal, by the psychic one, to deal with the conflict Pulsion nel, which is expressed then in the body (where, in the Hystérie, conversion is consequence of a psychical conflict).

This refusal to treat the conflict could be described as incapacity of representation - Mc Dougall takes the example of a patient who does not know that he suffers “psychiquement”. This incapacity of representation would come from a fault, even more radically of a cut, in the originating Processus conceptualized by Piera Aulagnier.

McDougall thus describes a bankruptcy in the setting in psychic scene. This failure would be appropriate for the subject, persuaded not to test any problem and not very concerned of a work on itself. It is what makes describe banal practices, for example to smoke too much, eat too much or drink too much, as the sign one to act being opposed to the development. The psychosomatic one would be to act on the body, and to attack the body would announce not only one disappearance of the psychical conflict, but also an attack of the mother, or rather of the partial Objet which is the unsoundable vacuum of the body-skin maternal.

The psychoanalytical Cure will make, in the best cases, to re-appear the psychic one and will create a “hysterisation” of the psychosomatic symptoms. obsessional defenses can be also set up. This process makes that McDougall brings closer psychosomatic states, and current neuroses, that it is about Anxiety neurosis (which would be, precisely, psychosomatic), of Neurasthénie or Hypocondrie.

McDougal also points on an aspect interrelationnel, describing for example answers refusing to the child his psychic life: “I do not love my brother” - “but if, you adore it! ”. Such answers induce a dramatic devalorization of the mental scene, and thus cause the psychosomatic answer. McDougall also points out the relational danger that is the Double bind (double obstacle).

Operational thought and lives

Pierre Marty indicates two concepts: those of Thought operational then of operational life. The psychic life is very reduced, very poor; the speech proves to be factual, without development; the psychic symptom cannot be elaborate.

Marty describes patients a priori far from favourable with the analysis, since they reduce their psychic life in order to be protected, that they escape in the factual one, in one to act being worth like Déni the psychic one.

The psychosomatic consequence is not a historical reference as in hysteria, but the displacement of a psychic faintness on the body.

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