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Psychosomatic phenomena remain peculiarly mysterious to me. By that I mean not only the ill-defined leap that associates disavowed affects with somatic symptoms. Nor do I refer only to the oddness of the experience of being with another person whose denied passions are felt in one's own gut. What particularly catches my attention is the observation that a patient may manifest his somatised conflicts in a series of physical symptoms that are medically unrelated. Patients may alternately have bouts of asthma, urticaria, irritable bowel and cardiac fibrillation, all of which may be analytically traceable to compromised transference communications. Yet they remain, at least until today, irreducible to a common organic substrate. In acknowledging the analytic common denominator of these multi-system outbursts one risks feeling like a medical pariah with our physician colleagues as well with many of our analytic friends.
In his book, Psychosomatics, Psychoanalysis, and Inflammatory Disease of the Colon, Charles Hogan provides a beacon of support, wisdom and deep experience in this area. Dr Hogan brings to our attention a review of the philosophy of the mind-body system and combines it with detailed psychoanalytic findings on the treatment of patients with inflammatory bowel disease (IBD). Together they offer the clinician both an historical and technical grounding with which to approach these most challenging patients.
In Part 1 Hogan introduces the study of IBD with a review of the medical and surgical approaches to its treatment. The pathophysiology, epidemiology and pharmacotherapy of the condition are also presented. As would necessarily be the case in a book presentation of these data, as opposed to a more current journal article, most of the references in this section are somewhat dated and are beyond the scope of my expertise. The many early references to the emotional conflicts that have been related to this condition are noteworthy, as is the frequent recommendatio