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404 Psychosomatics: Hearing the Body’s Discourse – 4 seminars

Course Leaders: Gavril Hercz, MD and Susan Moore, PhD, RP

Course Description

This course addresses the evolution of psychosomatics using a dual perspective. A conflict model initially elaborated by Freud, and subsequently others (Groddeck, Ferenczi, Klein), assumes symbolized communication becomes manifested physically. Freud also elaborated a nonconflictual deficit model of somatic expression, which was further elaborated by Alexander, Engel, McDougall and the French Psychosomatic School (Marty, de M’Uzan, Fain, Aisenstein). This latter perspective appreciates somatic expression as a lack of symbolization, with “unmetabolized” elements escaping psychic elaboration and therefore expressed somatically. Seminar 1explores the parallel evolution of these two models of somatic expression and the psychotherapeutic interventions that have evolved to address these manifestations. There will also be a consideration of newer perspectives of hysteria.

Seminars 2 and 3 highlight how early traumas and maternal interactions shape the mind/body relationship and may become manifested in the therapy. These seminars will also touch on universal disconnections in the mind body continuum in adolescence, reproduction and pregnancy, and aging and illness, which we all have to navigate. Additionally, in response to moving online during the global pandemic, Lemma’s reading explores the experience of the body in the virtual world.

Seminar 4 further explores psychosomatic manifestations of psychic trauma and the work that can be undertaken in these patients. The psychic manifestations of serious medical illness will also be discussed. Candidates will be encouraged to discuss their own clinical experiences concerning psychosomatic expressions from their own case material.

Course Objectives

Candidates will be able to:

  1. Appreciate the complex interplay between the psyche and the soma and how their mutual influences result in psychopathology (1.3c)
  2. Appreciate the impact of early or late physical trauma and how it becomespsychically manifested, especially at times of vulnerability (1.2.1). Look at how aging and illness in the patient or the analyst affects the psychoanalytic process.  (1.1.1)
  3. Understand symbolized and nonsymbolized dynamics in somatic expressions and how they fit into the major diagnostic categories of psychic expression. (1.3d)
  4. Discuss working with patients virtually on an electronic platform. Candidates will review Crpo’s “Electronic Practice Guideline.” (e.g., review agreement of electronic platform and gaining written informed consent, which includes statement of privacy and risk of harm; specifying that recordings will not be used in a session by the analyst or the client; making sure that liability insurance provider covers electronic practice.) (Standard 3.4)

Seminar 1

Required Reading

Bronstein C. On Psychosomatics: The search for meaning. Int J of Psychoanalysis. 92:173-195, 2011.

Aisenstein, M. The indissociable unity of psyche and soma: A view from the Paris psychosomatic school. Int J of Psychoanalysis. 87:667-680, 2006.

Seminar 2

Required Readings

Nissen, B. Hypochondria as an actual neurosis. IJP 99:103-124, 2018

Lemma, A.  An Order of Pure Decision: Growing up in a Virtual World and the Adolescent’s Experience of Being-in-A-Body. J. Amer. Psychoanal. Assn., 58:691-714, 2010

Seminar 3

Required Readings

Mitrani, J.L. Bodily Centered Protections in Adolescence: An Extension of the work of Frances Tustin. Int. J. Psycho-Anal., 88(5):1153-1169, 2007.

Lombardi R, Pola M. The body, adolescence, and psychosis. IJP 91, 2010 – Issue 6

Seminar 4

Required Reading

McDougall J. Theaters of the Body. A psychoanalytic approach to psychosomatic illness. Chapter 1,2.  Free Association Books, Ltd 1989

Winnicott DW. Psych-Somatic illness in its positive and negative aspects. Int J of Psychoanalysis. 47:510-516, 1966.

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