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Having embarked on psychoanalytic consultations with somatic patients in the late 1950s, 10 years later Pierre Marty was at the helm of a research group that also included Michel de M’Uzan, Michel Fain, and Christian David, which was to lay the foundations of an entirely new approach based on the observation and study of the mental functioning of such patients. The publication of their book on psychosomatic investigation (L’Investigation psychosomatique) in 1963 was the founding act of what has since been known as the Paris Psychosomatic School. Marty and de M’Uzan described “essential depression” and “operational thought” at a time when Nemiah, Freyberger, and Sifneos (1976) in the United States were using the term “alexithymia.” All were considering a psychopathology characterized by the manifest absence of emotional and phantasy life in psychosomatic patients.
Innovative in form, L’Investigation psychosomatique (Marty, de M’Uzan, and David 1963) presents comprehensive records of interviews between psychoanalysts and patients and puts forward a number of embryonic concepts. These include one of the key notions of this new school of thought, that of dementalization, which expresses the negative or deficient aspect of mental functioning—namely, poverty of dialogue with the analyst and the lack of systems of psychic expression concerning internal or external objects. A succession of major discoveries were to follow, based on one of Freud’s earliest conceptions, that of actual neurosis.
Marty (1980, translated) writes that in a psychosomatic patient,
the mental activity of representation is insufficient and reduced to the role of accompanying the relationship with the external object, so that a part of the subject’s instinctual, drive-related energy escapes the mental work of processing and integration and can ultimately disturb a somatic functional organization (85).
This can be seen as nothing less than a conceptual revolution in the field of psychoanalysis. It postula