[Somatic gain, somatic transfer and somatic neurosis]

Whatever the aetiology of a somatic disorder-symptom of full-blown illness-meaning is conferred on it from the outset, and it is integrated into the patient's psycho-somatic economy. The author proposes the term gain to encompass the meaning and economic adjustment resulting from somatization. It plays an essential part in the development of the somatic disorder and every therapeutic programme must take it into account. The psychic disorder resulting from a somatic ailment may give rise to a true neurosis, depending on the mental organization prevalent at the time the somatic condition occurs. The author proposes the term somatic neurosis as an appropriate description of the neurotic psychic consequences of somatic disorders. This neurosis is linked to the gain that somatization brings and is the result of displacement of unconscious problems onto the somatic symptom. The author attempts to demonstrate the heuristic and therapeutic relevance of defining the psychic elaboration of physical illness as a somatic transfer.