You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
February 23, 1981. COMBINATORIAL SPECIFICITY AND THE COMPLEMENTAL SERIES. (Melitta Sperling Memorial Lecture.) George H. Pollock, M.D.
Referring to the etiology of psychosomatic disorders, Dr. Pollock described the concept of "combinatorial specificity" as an outgrowth of the Chicago school concept of conflict specificity. This concept was clearly heralded by Freud in his notions of the "etiological equation" and the "complementary series." We now know of correlations between psychosomatic illnesses and various elements, such as specific conflicts, specific personalities, specific mother-child interactions at certain developmental periods, biological predisposition, etc. The concept of combinatorial specificity, however, addresses questions of how much, how long, and in what combinations these elements appear in psychosomatic disorders.
As early as 1892, Freud struggled with questions about the relationships among the different "causes" involved in "bringing about" illnesses. His discussions dealt with the interlocking between heredity and experience. In the Three Essays he wrote that the relationship between constitutional and accidental factors is "cooperative and not a mutually exclusive one. The constitutional factor must await experiences before it can make itself felt; the accidental factor must have a constitutional basis in order to come into operation." Dr. Pollock added that today we can be more specific about constitutional factors since we are able to distinguish genic predisposition from external factors as early as four or five months after conception. We can also identify factors which previously were considered to be constitutional but which are now thought to be externally induced in utero and to organize the central nervous system in a way to predispose the neonate to certain behaviors.
Freud described a model of latent neurosis due to the relationship between constitution and predispositions acquired in childhood experiences which may be t