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The psyche and the soma are not to be distinguished except according to the direction from which one is looking.
[Winnicott, 1949, p. 244]
THE CREATION OF MODERN PSYCHOSOMATIC medicine as an integrated discipline dealing with the psychological concomitants of physical maladies, the study of psychological reactions subsequent to organic illness, and the interaction between psyche and soma in the production of disease is historically bound to psychoanalysis. Early on in his formulation of the libido theory, Freud (1900), (1905) appeared cognizant of the profound effects of the soma upon the psyche. He proposed that the life force itself was derived from bodily functions and demonstrated their significant impact upon mental life (1895). Freud's contribution of the two models of the pathogenesis of bodily symptoms (those seen in conversion hysteria and the 'actual' neuroses) was significant in the early development of psychosomatic theory and has remained both the basis for and the problem of psychosomatic research for over half a century.
While reflecting upon Freud's early work, one is struck by his acute awareness of the 'constant conjunction' (Bion's term) between