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Reflecting on the way the body is presented in analysis, Bolańos reviews her clinical caseload. Bodily expression transcends the spoken word, yet only the latter implies development, both biological and mental, of certain psychic structures. In some situations the body acts as the only means of expression; is this intentional? Libido is transformed into somatic innervation. In other cases, the soma manifests an inhibition in development; sensations never make it into the psychic world, the world of meaning. Is there a phase-specific—oral, anal, genital —language for the body? The author refers to McDougall, Anzieu, Liberman, Green, and the views of Marty, de M'Uzan, and David, who all converge on the notion of deficiency in symbolization in the psychosomatic patient who cannot insert affective experiences of the body into the linguistic code.
A six-year clinical case is described in great detail: an adult woman in whose analysis an autistic nucleus was revealed. Once analyzed, this encapsulated area of the mind revealed itself in the development of a new musical talent that allowed the patient to work musically with autistic children. Through analysis of the somatic symptoms that surfaced in the session, and their associations, she began a process of enriched symbolization.
Body expression can be read as “noncommunication” or as a message. Referring to Milner and the idea that fusion and identification are precursors of symbolism, the author discusses the meaning of worldlessness within the analytic process, forms of primitive expression which, in some cases, can be put into words by the analyst.