The Role of Physical Form in Psychodynamics*

The history of psychodynamics began with the psychological interpretation of a physical symptom—the paralyzed arm of Breuer's patient, Anna O. As Freud delved into the genesis and meaning of neurotic symptoms he discovered the crucial importance of the psychosomatic history of infancy. It centered on the organs on which the survival of the infant depends. As has been demonstrated most strikingly by Spitz, 22 survival depends at no point on the satisfaction of physical needs alone. The physical processes serve the development of the infant only to the extent to which the needs of the infant are met by the psychological attitudes of the persons on whom the infant depends. Their oral, anal and genital attitudes make their “imprint” 13 and determine the effect of the physical experiences on the future health of the infant which survives.

The psychosomatic basis of psychoanalysis has proven its value in the theoretical and therapeutic experiences of the last half-century as far as the understanding of the neuroses and psychoses is concerned. When medicine became aware once more of the role of the psyche in physical diseases, it was natural that the personality of the patient was approached with the methods and presuppositions of established psychoanalysis. It could be demonstrated that the emotional tensions of organically ill patients could be understood in the same way as in psychiatric patients. Obviously the basic functions of the infant stay basic also in the life of the adult. Psychoanalysis could explain how the organic patient became sick and it could also demonstrate that oral, anal and genital functions could be symbolized by other organs of the body.