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Psychoanalysts who work in the area of psychosomatic medicine and its cousin, the study of the psychological components of physical illness, seem to me to be unusually courageous, if not somewhat foolhardy investigators. The field does not offer the infinite richness of experience one finds when one immerses oneself in the complexity, variability, and exciting uncertainty of the behavior we associate with psychopathology. Nor does it offer the comforting certainty of intellectual explanations built around the operation of loosely coupled variables and linear causality we associate with the study of the pathophysiology underlying physical disease. Psychosomatic medicine confronts the scholarly researcher-clinician—and Taylor is clearly in the first rank of such workers—with all the burdens of two incompatible orientations and few of the occasional gratifications that occur with either orientation. This dilemma, arising from two fundamentally different approaches to the study of the same complex, overdetermined phenomena, has accounted for many of the inappropriate, simple-minded efforts to apply psychoanalytic conceptualizations in the past. Psychosomatic theoreticians of the past, who believed themselves to have been informed by psychoanalytic thinking, have often sought refuge in the solution of the blind wise men of Hindustani who, when confronted by the elephant, opted for a series of single factor explanations based upon utterly incompatible but "certain" descriptions.
Taylor has written an excellent historical review and analytic inquiry into efforts to utilize psychoanalytic concepts to understand the origin, mechanisms, and control processes involved in the classic psychosomatic illnesses. My only significant criticism relates to his hedging on the clinical therapeutic implications of the impressive "deregulation-miscommunication" model which he constructs to explain the unique origin and nature of psychosomatic illnesses.
In his first one hundred pages,