The Choice of Organ in Organ Neuroses1

An organ neurosis is the necessary expression of a neurotic conflict in terms of an organic disorder which has a specific character. The organ involved is determined by the fact that it was originally affected at a time antedating the full evolution of instinctual life. The instinctual response at that time to the organic dysfunction created a psychosomatic unit, i.e. an active or latent co-ordination of, and interaction between, a given organ and a psychic conflict. This psychosomatic interrelation will be used under certain somatic or emotional conditions as the pathological solution of a psychic conflict and will lead to a certain symptom complex. Thus when the old psychic conflict becomes active, the organ originally associated with the conflict is called upon to produce those symptoms. In the case of certain specific conflicts, we shall witness manifestations of both components whenever one is stimulated, reproducing the other component of the original situation. More specifically, a certain phase of an emotional complex becomes causally and by necessity related to a certain organic dysfunction.2

A mutual interaction between emotional and physiological processes must be considered to be present permanently in every human being, independently of whether the total function of the organism proceeds normally or abnormally. This presupposes a continual fusion between somatic and emotional processes inherent in the physiological or pathological function. If the pathological emotional process was able to invalidate the organic function, any repetition of this pathological process may lead to the same patho-physiological response and may be the only expression of this pathological emotional process. This implies that the same disturbance may arise when a pathological organic process coincides with a situation of emotional conflict which would have been solved without difficulty if the physiological function