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Gérard Szwec is a referential author in psychosomatics and in particular in the field of working with children. His work is an extension of that of Pierre Marty and especially of Michel Fain, founders with Michel de M’Uzan and Christian David of a branch of psychosomatics called “L’École de Paris”. The originality of this School is to position somatic disorders not as meaningful symptoms, as in hysteria, but on the contrary as having the meaning of a failure of mentalization, testimony of a disorganization, which suddenly reaches the soma, sometimes seriously.
L’investigation psychosomatique (Marty, de M’Uzan and David 1963) sets out to evaluate the functionality of mentalization in hospitalized patients with somatic conditions. The clinical examples give an account of the limits of conflictualization and psychic symbolization, with a poverty of oneiric life and of fantasies, thought and behaviour becoming operational. The preconscious seems to have lost its thickness. And even anxiety can disappear in an essential depression. The therapeutic implications are important because classic psychoanalytic treatment then involves an element of danger, and face-to-face work is preferable with a more active verbal presence of the analyst.
We can advise those who are not familiar with the difference from other psychosomatic fields to start the book with the last chapter, which takes up the history of these ideas after Freud. It describes the creation of the “Paris School” and articulates its specificities in relation to “The Chicago School” around Franz Alexander in the 1930s, or to the works of Winnicott and, in France, those of Jean-Paul Valabrega. It also shows the differences between the thinking of Pierre Marty (1979) and Michel Fain. The former insists on the opposition between the organization and the disorganization of psychic functioning. In the failure of the psychic capacities of regression, especially formal regression, the disorganization is accentuated and is prot