Prologue

The inspiration for assembling a group of papers on the relationship between bodily experience and mental states came from reflections on clinical work. One of us (D.M.L.) came upon an unexpected development in the course of psychoanalytic treatment and found that the appearance or exacerbation of somatic symptoms proved to be a signal that dissociated and formerly invalidated traumatic memories and the affects associated with them, were crystallizing and being retrieved in the analysis. These clinical observations were in sharp contrast to the vast majority of psychoanalytic concepts regarding somatization. The appearance of somatic symptoms is generally explained as a sign of regression resulting either from the patient's defensive maneuvers or from the patient's reaction to a failure in empathy on the part of caregivers during development or on the part of the analyst in the course of treatment. In this instance, the emergence of somatic symptoms constituted a developmental achievement in the context of a validating, archaic bond with the analyst. Subsequently, these symptoms disappeared when the analyst was able to fathom, articulate and link the somatic, visceral, sensory, and motoric aspects of the patient's experience to figures from early childhood and the affects associated with them. The fragments of the patient's inner world became integrated. She began to experience her body and mind as two inextricable aspects of an indivisible whole.

These observations raised questions that pertain not only to somatization, but also to the broader subject of the connection between body and mind. The first questions, those concerning somatization, focus on a reexamination of what is encoded in somatic symptoms. Are symptoms or the emphasis on bodily experience an early form of affect? Do symptoms appear in the course of an analysis when an affect state is newly mobilized? Are somatic symptoms or emphasized bodily states concrete referants as well as concretize