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This fascinating topic has historical links with the origins of psychoanalysis and with Freud's pioneering contributions on the role of sexuality in mental and somatic illness. It is also linked to the issue of the relation between the mind and body, something that has exercised philosophers from the earliest times and has subsequently been of great interest to psychology and psychoanalysis.
The Chairman opened the panel and proposed a format for the presentations and the subsequent discussions.
The first panellist, Clara Helena Portella Nuñes, began by briefly reviewing Freud's views on sexuality and hysteria and on the somatic aspects of sexuality. She observed that in current thinking on sexuality and somatic disease, however, what is implied is early sexuality in the context of the mother-baby relationship. Acknowledging the contributions of Klein, Winnicott and McDougall, she stated that the split between psyche and soma is a common feature of all psychosomatic patients. Their soma is felt as a foreign body persecuting their mind from outside. She described her work with a male patient in his early fifties who was entirely preoccupied with descriptions of his physical symptoms, ranging from urinary/prostrate complaints to rheumatic pains. Attempts to explore psychological meanings were rejected by the patient, who apparently insisted on the convincing quality of his ‘objective reality’.
He was also greatly hypochondriacal and subjected himself to numerous painfully invasive physical examinations. However, there appeared to be an inability to feel psychic pain. He felt unattached to everyone around him including the analyst. Transferentially, the analyst represented both the mother to whom he handed over his suffering body to be soothed and the envious mother who would punish him for being so rich by making him ill. The loss of his father in the third year of treatment brought up the theme of death. While his only feeling was relief at not having to visi