The Application of the Simulation Model of Neurotic Defence Mechanisms to the Psychoanalytic Theory of Psychosomatic Illness

An attempt has been made to determine, with the categories of the defence model, what a chronicized psychosomatic state would have to look like when formalized. Distinctions from other forms of neurosis can be found in the simulation process by variation of the parameter values. The setting up of the model hypotheses has been based on the findings of psychoanalytic research on psychosomatic states. However, there can be admitted only those concepts which can be represented in the formalization of the defence model. The following concepts have been described: the releasing factor is to be found in the immediate anxiety defence to avoid the emergence of manifest anxiety as a result of conflict reactivation. Somatization replaces the repetitive use of emergency defence mechanisms. Neurotic anxiety-unpleasure must be kept apart, so that it does not become experienced. Developmental factors favouring a psychosomatic development are: insufficient counter-cathexis potentials (DC₁, DC₂, DC₃, a), slightly developed capacity to elaborate fantasies with anxiety tensions (g-fantasies), frequent, regressive b-fantasies, well-developed cathexis displacement (b-potential), also slight cathexis displacement with little difference between anxiety-unpleasure and pleasure values, low cathexis values on the self-representations, high anxiety values on the object-representations, cathexis displacement from the object-representation to the self-representation (identificatory defence in the object-relationship), non-use of

pre-oedipal defence potentials (cathexis defence, R-potential). The stabilizing factor is the lasting reduction of the actual cathexis, which prevents further anxiety attacks from occurring, and as a consequence, autonomy is diminished. The psychosomatic state is the result of equilibration with the help of cathexis displacement (with differential regressions). Freedom from anxiety is paid for by the reduction of the cathexis. Somatization prevents the utilization of previous defence processes which have been used in the state of diminished inner and outer autonomy (so-called cathexis defence).