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Somatization: a perspective from self psychology.

G M Rodin1

  • 1Department of Psychiatry, University of Toronto.

The Journal of the American Academy of Psychoanalysis
|January 1, 1991
PubMed
Summary
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Somatization, often seen in psychiatric disorders, can stem from disturbances in self-cohesion or defense mechanisms. Building a stable sense of self through relationships can alleviate these somatic symptoms.

Area of Science:

  • Psychiatry
  • Psychoanalysis
  • Self Psychology

Background:

  • Somatization is a complex phenomenon observed across various psychiatric disorders, not always pathological.
  • Traditional psychoanalytic theories focused on drive, conflict, and defense in conversion disorders and hypochondriasis.
  • Self psychology offers a complementary perspective emphasizing subjective experience and the sense of self.

Observation:

  • Disturbances in self-stability and organization can manifest as somatic symptoms and impaired emotional awareness.
  • Somatization may represent an experiential outcome of disrupted self-cohesion or a defense against overwhelming affect.
  • The threat of psychological fragmentation can intensify somatization when affective arousal occurs.

Findings:

  • Self psychology enhances psychoanalytic understanding of somatization by focusing on the self.

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  • Somatic symptoms can be linked to a fragmented or unstable sense of self.
  • Defensive operations against affect, particularly the threat of fragmentation, play a role in somatization.

    • Implications:

    • Forming supportive self-object relationships can consolidate the sense of self and reduce somatization.
    • Integrating affect into subjective experience is crucial for psychoanalytic treatment of somatization.
    • Understanding somatization through the lens of self psychology offers new therapeutic avenues.