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FROM THE FIRST PATIENTS treated by the psychoanalytic method, the "mysterious leap of the mind to the body" (Freud, 1955) has puzzled many. The analytic exploration of somatizing patients, as Engel (1968) noted, can be the "best source of material for gaining insight into the unconscious determinants and the metapsychology of the critical psychic states involved with the genesis of somatic disorder."
Two patients suffering from rheumatoid arthritis, depression, and obsessive-paranoid disorders were treated in psychoanalysis. Throughout the course of each analysis, my aim was to participate in an unfolding without the comfortable feeling that all was or could be understood in terms of Cartesian or psychological hydrodynamic frames of reference (Stainbrook, 1964).
These cases are presented to learn more about the physiology, familial, interpersonal, and intra-psychic aspects of the disease. Scheflen's (1969) admonition is valuable. Disappointment may follow those "who try to make simple one-to-one correlations between psychic and somatic variables. The problem is that they have been studying them whatever their theory from different levels of organization. To study a system we may break it down into parts as a step in the investigation, then synthesize to examine organization. There are no independent variables in a system."
The etiology of rheumatoid arthritis is unknown (Robinson, 1966). Research has failed to substantiate infectious, endocrine, autonomic nervous system, or genetic origins. The personality