PROLOGUE

The idea that there is an intimate relationship between body and mind has been around since antiquity. The recognition of the psychogenic aspects of asthma has been attributed to Hippocrates, who supposedly warned that asthmatics must guard against anger, and today new knowledge from a variety of disciplines affirms the existence of a complex, fascinating, and intricately entwined mind–body.

Psychoanalytic interest in this topic has waxed and waned over the history of the field. The enthusiasm first generated by Freud and his early followers declined rapidly, as clinical research failed to support proposed psychoanalytic theories, and psychoanalysis itself failed to yield the hoped-for cures. Fewer symptomatic patients were referred by other professionals for treatment, and fewer patients came seeking treatment on their own for psychosomatic disorders. Moreover, many patients still have no wish to explore the accompanying personality issues that underlie physical distress, and, when they are fortunate, advances in medical treatment can ameliorate their symptoms enough to satisfy them. As our theories of the body–mind have developed to include research findings from other disciplines, however, and our understanding of the relationship between mind and body increases, the investigation into psychosomatic disorders has, once again, become a topic of interest to psychoanalysts. And this is a timely development. Patients still arrive in our consulting rooms to deal with the stresses of psychosomatic complaints, even if not specifically for the treatment of the disorder. They come with gastrointestinal problems, eating disorders, migraines, intractable eczema, urticaria, mysterious aches and pains, and the general feeling that the specialists who treat them do not understand them. For many of these people, psychoanalysis or dynamic psychotherapy brings the relief they seek. And some patients ultimately appear in our offices out of discouragement, after a lengthy journey th