Tuesday, September 16, 2014

Psychosoma Intro

The body remembers. Early traumatic experience, whether occurring before the hippocampus comes ‘on-line’ or dissociated from symbolism by decreased blood flow to the otherwise functioning hippocampus, is procedurally ‘learned’ and stored by affect and perceptual senses. Chronic thigh pain may be the only link to the pain of childhood sexual abuse, the smell of a particular cologne and its consequent headaches the only connection to herald long ago parental tirades.  We feel. We panic. We don’t remember the events. It may take countless hours of psychotherapy before integration and words allow voice to be given to those early threats to sense of self.

In Theaters of the Body (1989) Joyce MacDougall writes that psychosomatic illness results from the body reacting to a psychological threat as though it were a physical threat due to lack of awareness of our emotional states when being threatened, so seeking psychological treatment is very tricky for both patient and therapist. While one may wish to be free of psychological (and psychosomatic) symptoms, we must remember that these symptoms have been, since childhood, a best possible attempt at bearing the unbearable. Our patients wish and fear the giving up of these symptoms for these symptoms helped (in earlier times) with psychic survival. They may also be the only clues we have to early traumas.

Kradin, from a Jungian perspective, provides an introduction to the psychosomatic illnesses. He states that the psychosomatic symptom is “a symbolic communication by the suffering self to caregivers…a cry for help in hope that someone will respond, and a method of repelling others as an expression of unconscious dread.” Early caregivers regulate infant distress and give meaning to infants’ bodily sensations. The failure of symbol formation in people suffering with psychosomatic disorders speaks, in part, to the inadequate regulation between mother and infant. Kradin highlights (from Noyes) the anxious maladaptive attachment style where (from Driver) etiology of at least one disorder, CFS, is speculated to include “inadequately internalized maternal reflective function, affect dysregulation, and diminished psyche-soma [Winnicott] differentiation.” Other events often found in the histories of patients with psychosomatic disorders are “a parent with physical illness, a history of family secrets, and childhood maltreatment” including emotional abuse. Kradin reminds therapists that our aim is treatment of the disordered self and not symptom reduction. “[S]ymptoms are ‘real’, whatever their cause” and “healing begins only once caregivers have disabused themselves of the notion that patients are responsible for their disease.”

Kradin, R.L. (2011). Psychosomatic Disorders: The Canalization of Mind into Matter. J. Anal. Psychol., 56:37-55.

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