You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
This panel opened with Diane Le Beuf's presentation which took into account the Freudian concept of ‘mixed neurosis’: psychoneurotic symptoms and ‘actual symptoms’ may be present together, as well as psychical symptoms of different psychoneurosis. This allowed Mme Le Beuf to notice that it is not the presence of a symptom as such which determines the régime, but its relation to the psychical organisation, as well as the clinical assessment of its economic character. She also acknowledged that there is a close relation between the Freudian idea of ‘actual neurosis’ and somatoses, because the excess or the accumulation of excitation which cannot be worked through deviates into the somatic.
She then referred to the existence—or not—of a psychosomatic structure. Mme Le Beuf expressed her own ideas regarding this, saying she prefers to think in terms of the mode of psychical functioning rather than in terms of structure, but that she still believes in the notion of short-circuiting of psychical working-over. Somatic illness appears within various psychical organisations.
She then focused on the technical approach of patients suffering from somatic disorders, wondering if the interpretations the analyst formulates are different from the ones used in the so-called classical cures. Going beyond the real somatic complaint, the analyst tries to put words to things, to create connections so that the patient can make links between the different elements of what he says. The idea is to make possible the transition from the ill body (the soma) to the erotic body. Mme Le Beuf then presented excellent clinical material of a man suffering from a disabling cephalgia which raised questions about these important issues: the coexistence of different levels of psychic functioning; the changes in the normal frame; the modes of interpretation with these kinds of patients; and the importance of transference and countertransference.
John, the patient, was 30 and cephalgia had first appeared at