Body and Somatic Event. Prehistory and Potential for Repetition: José F.. Fischbein. Pp. 131-151.

The concept of the body underscores the limitations of psychoanalysis. First experiences are somatic: their emotional register is part of the prehistory and protohistory of mental organization. Psychoanalytic theory is organized around body metaphors. In Studies on Hysteria the body is placed in front of the scene it hides. Only the acquiring of representations permits the body access to consciousness.

Various levels of psychopathology emerge from the distinction between somatic body and erogenous body. The body, with its needs, presents to the psychic apparatus as an object against which to defend. Considering the body as a concrete, asymbolic vertex in psychosomatic pathology, psychoanalytic treatment attempts to create a system of meaning that gives the subject a form of mental expression. Fischbein illustrates his ideas about the role of psychoanalytic treatment in psychosomatic disorder with a highly detailed, rich clinical case: a thirty-two-year-old man facing a gastrectomy for chronic ulcer who begins an analysis that will last seventeen years. For the author, the main instrument in the psychoanalytic approach is the creation of constructions about early object relations and the analysis of their repetitions in the form of the somatic event in the transference. A discussion of “mental anatomy” follows. The breast, which does not make demands, is the nucleus of the ideal object. The body begins to be felt as belonging to the space “not-me.” The peremptory demands of that body not only threaten the baby, but also the mother. The early ego, the “I” of that moment, is a shared “I,” which faces the massively imposing soma. The mother of this kind of patient demands an early adaptation at the psychic level that is based on splitting and alienation from the child's own affective states. Some of these mothers demand precocious regulation of self-esteem.

Signal anxiety is deficient and the preconscious system is inhibited, both factors that favor acting-out. The somati