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When we talk about the life cycle, it is usually with respect to developmental tasks that are either attained or incompletely dealt with at specific phases of life. Ordinarily we don't think of medical illness as part of the life cycle. Yet whose life is without major illness? Perhaps we are inclined not to consider physical illness a natural part of the life cycle because it's occurrence is so variable and to a large extent unpredictable. Perhaps also because physical illness is so ego dystonic, unwanted, and seemingly inflicted on us unfairly from outside our own being.
Psychoanalytic practice has been so uncomfortable with the psychological meaning of physical illness, that almost all our theory of mind has been lifted entirely out of the physical realm of the body. We have made the transition from the accommodation of instinctual drives through the adaptation of ego psychology to the purely psychological realms of object relations. The corporal body has been left behind! The notion that the mind is first immersed in the body is as old-fashioned as drive theory. And, today we are more comfortable with the concepts of object relations, projective identifications, and negative therapeutic reactions.
But, what about the old concept of body image: How does it apply in today's theory? What is its implications for psychoanalytic technique? How relevant is it for understanding behavior during periods of physical illness? I am reminded of at least three psychoanalysts I treated, for various time frames, two of whom were training analysts. They all reacted to their ordinary physical illness with statements to the effect of “I never thought that anything like this would ever happen to me.” There was an expectation that one could pass through life intact without being affected by insults to the physical self. This article will review