[Basis disturbances in depressive neuroses and psychosomatic disorders]

Applying the concept of the "basic fault" (Balint) to depressive neuroses and psychosomatic disorders the author reports some analogies in the dynamic processes of both diseases. Both are based on a pre-verbel deficiency in communication which has an influence on further conflict-organisation. In the case of psychosomatic diseases this leads to a fixation on the pre-verbel, vegetative object-relation. At the stage of the re-activated psychovegetative basic fault only somatic reactions and satisfactions may be accepted by the patients. This impedes the working alliance, consolidates somatisation as a resistance mechanism, and may require discontinuation of psychoanalytic treatment. In the case of depressive neuroses the stage of the basic fault is characterised by a paradox form of sell-object-relationship which is both object-relation and narcistic isolation as well. Though at this stage verbal communication is less important the analist may advance dissolving of this paradox relationship by means of empathetic interventions.