Problems in Heart Neurosis

Concern about the increasing incidence of psychogenic bodily disturbances has led in recent decades to voluminous research which is difficult to survey. Different medical disciplines and research approaches including clinical psychology have been used in this effort. Findings are difficult to integrate, and I shall confine myself in this paper mainly to psychotherapeutic investigations.

As far as I am aware analytical psychology has not so far made any essential contribution to psychosomatic medicine. The Jungians who have occupied themselves with psychosomatic problems include in their bibliographies the names of well-known psychoanalysts, and seem to employ heterogeneous concepts and approaches.

Discussing the reason for this state of affairs, C. A. Meier (1961-2) makes the point that the primacy of the psyche and the autonomy of mental processes in Jungian psychology has led to a concentration of attention on the phenomenology of the spirit rather than on clinical phenomenology. Diagnosis was made in terms of problem, complex, and dominant archetype, and ‘aches and pains’ were felt to be less relevant (p. 625).

I believe that analytical psychology, with its special terminology, is able to make essential and clarifying contributions to the problems of psychosomatic medicine. First, I should like briefly to contrast the basic conceptions of both. The pathogenetic model of psychoanalysis places disturbances of development of the libido at the centre of its approach. The dynamics of the interactions between ego and id, and ego and superego, and the economics of these processes are the essential determinants of the psychopathological events.

Psychosomatic medicine has elaborated this model in one instance. In Alexander's research ambivalent tension due to conflicting drives is central to his pathogenetic model of psychosomatic diseases. For example, frustrated oral receptivity and reactive oral aggression constitute the dynami