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Fain opens the discussion with some thoughts about the place of psychosomatically oriented psychoanalysts on the French psychoanalytic scene: they work to some degree in isolation, and although their papers and reports do appear in journals such as Revue Française de Psychoanalyse, it is almost furtive. There are theoretical and metapsychological reasons for this isolation. In work with psychosomatic patients, the notion of regression is quite different from that encountered in work with the usual psychoanalytic patient. The type of disorganization described by Pierre Marty becomes prominent. Two principal concepts have been developed to explain regression in psychosomatic illness: operative thought and essential depression. Operative thought is so called because it does not involve associative preconscious links which are countercathected. In other words, it has no tendency to become sexualized. Marty has now come to use the term "operative life." In these patients, the work of dealing with and modifying reality is done without arousal of any unconscious reaction, and day-to-day living is carried on devoid of associative links to unconscious material. Essential depression was at one time designated "objectless depression," but the adjective "essential" is justified by the lowering of functional level without the customary compensating depressive symptomatology of self-accusation, loss of self-esteem, and loss of interest in the self.