The Psychosoma and the Psychoanalytic Process

It is much more important to know what sort of patient has a disease than to know what sort of disease a patient has.

C. H. Parry (1755–1822)

The difficulties of being human oblige us to create an infinity of psychic structures to bind or in some way cope with the inevitable physical and mental pain we are going to encounter. We have to start doing this shortly after birth and are only able to do it because of a unique phylogenetic heritage: the capacity for symbolic functioning. Most of our psychic pain is occasioned on the path to acquiring individual status and personal identity followed by the acquisition of our sexual identity. Freud was the first to emphasize the essentially traumatic nature of human sexuality while Klein and her disciples have thrown light upon the earlier traumata inherent in the process of separating one's image from that of the primordial Other in order to become a person. We must find answers early on to the conflicting claims of instinctual life and reality demands which these processes bring in their wake, and for the rest of our lives much of our psychic energy will be directed towards maintaining the solutions we have found. Some of these solutions make life a creative adventure while others are maintained at the expense of psychic, and eventually somatic, well-being.

Anthropologists such as Lévi-Strauss postulate that sexual laws of some kind are inherent in any social structure in that they are the minimal requirement for distinguishing a social group from a herd such as may be found in brute nature. In psychoanalytic theory insight into the complexities of social and sexual integration is attained through the concept of the oedipus complex, the notion of castration anxiety and of the symbolic structures to which they refer. These relatively sophisticated structures are intricately bound up with language and indeed could not exist without it. Beyond them lies the darker, infra-verbal and pregenital area, less weighted semantic