A reconsideration of psychological specificity in psychosomatic disorders

In this paper, the author identifies the evolution of the specificity hypothesis in the psychogenesis of psychosomatic illness across the last half century. Specifically identified is the distinction made between the mechanism of conversion and that of vegetative neurosis. Considerable attention is addressed to the personality features thought to be common to all psychosomatic patients and the refinement of this theory over the past 40 years, including the present interest in alexithymia. These concepts are explored in the consideration of a man who sustained two different specific conflictual environmental situations. The author emphasizes that our present formulations lead us to focus on the person with the illness and the processes that lead to that illness in the patient.