Hypochondria Versus The Relation To The Object

In the context of ideas of Freud, Klein, Bion, Rosenfeld and others on hypochondria, psychic development and object relations, the author presents the case history of a female patient who anxiously takes flight from the analyst's interpretations into somatic pains. The experience of separateness and of the ‘facts of life’ is so unbearable to her that she prefers a dialogue with her body to one with the analyst. Cathexis is withdrawn from the frustrating external object and transferred to an organ of the body, which, however, also proves inadequate and is hated, because, as the author shows, the processes of projection and introjection are inescapable. Clinical material is given to demonstrate how the patient uses hypochondriacal states to ward off a psychotic breakdown. Progress ensues when the analyst realises that the patient's hypochondria is a form of communication in body language. In a particularly telling sequence, the patient physically averts her eyes from the unbearable reality of a rose in the consulting room because it stands for the separateness of the analyst. But interpretation gradually ushers in processes of symbolisation, whereby the concrete physical injury felt by the patient to have been inflicted on her by the sight of the rose is turned into a symbolic ‘allergic’ reaction and the allergy becomes metaphorical.