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This book investigates the relationship between body and psyche in ‘the synthesis and contextualization of experience’. It explores the function of the soma as a repository for aspects of experience withheld from consciousness in a condition referred to by the author as ‘knowing-and-not-knowing’. This, she describes as ‘a borderland of consciousness where experience is registered in some form, but only diffusely thought, if thought at all’. Certain states of anxiety, along with other neurotic and somatic symptoms are portrayed as expressions of knowledge that have not been adequately represented to consciousness. In this respect these ‘knowing-and-not-knowing’ states resonate with what Christopher Bollas (1987) calls the ‘unthought known’ whereby patients express, through the transference, aspects of their early object relations that have not been mentally represented. Costello translates these unrepressed contents of the unconscious into a Jungian language and calls them ‘somatically expressed complex-fragments’. She extends Bollas's argument and ascribes these unconscious contents not solely to early object relations but also to an ‘interplay of archetypal, cultural, and later developmental factors’.
The author accepts, as Kalsched (1996) described with traumatized patients, that somatization can be understood as a defensive mechanism in that it protects the individual from experiencing unbearable psychic pain through the inhibition of mental representation. However, she argues that somatization plays an important part in the resolution of psychic conflict in her observations that injury and illness often precede ‘the emergence of insight or the resolution of perceptual distortions’. She illustrates this with both clinical examples and an interesting biographical case study of Albert Speer in his relationship with Hitler. Speer is portrayed as being blinded by both archetypal and personal factors in his love and admiration of Hitler and that it was only a hospitali