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.
(Accepted for publication 26 October 2014)
The last few years have witnessed a renewal of interest in psychosomatics in English-language literature, as evinced by the publication in the International Journal of a number of papers (e.g. Aisenstein, 2006; Lombardi, 2008; Solano, 2010; Pirlot and Corcos, 2012) and the translation of Marty's essay on the narcissistic difficulties presented by the psychosomatic problem (Marty, 2010), as well as the simultaneous publication of three contributions each illustrating a different approach to the subject (Bronstein, 2011; Smadja, 2011; Fischbein, 2011). While so to speak engaging in an indirect dialogue with several of these authors, the present publication adopts what I believe to be a relatively novel perspective, concentrating on the epistemological and clinical issues arising in the process of theorization in the psychosomatic field. What is the relationship between a theory and the clinical practice for which it seeks to account? What is the purpose of our theories? These questions obviously arise for every psychoanalyst, given that our activity does not readily lend itself to the classical scientific model's verification procedures. However, as I shall endeavour to show, these problems are not only particularly acute in the sphere of psychosomatics, but also constitute an essential first step in testing the value of our theories. My argument will be presented in four stages.
I shall begin with a general review of the links between theory and clinical practice. Whenever facts are incorporated in a theoretical formalization, the other side of the coin is in my view a defence against the unknown to which we have not yet succeeded in imparting a form. In other words, our theories necessarily have two aspects: creative formalization on the one hand, and, on the other, resistance to, or indeed flight from, this most disquieting facet of the unknown, in that any failure in the formalization of the object of our research is bound