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This chapter contains a description of the successful psychotherapy of a 52-year-old man suffering from chronic and severe upper gastrointestinal pain accompanied by nausea, anorexia, and weight loss. The therapy took place over 18 months and consisted of mostly once-weekly sessions, with the exception of the first three months, during which the frequency was twice-weekly.
There were several features of this case that may be of interest to clinicians working psychodynamically. First, the chronic and severe somatic symptoms were able to be successfully treated on a mostly once-weekly basis in a relatively short period of time. Second, the establishment and analysis of what I am calling a desomatizing selfobject transference was the basic therapeutic tool. This term refers to a multifaceted transference configuration that embodies idealizing and affect-integrating selfobject functions that are fundamentally tied to the process of desomatization. Finally, an unusual aspect of the case was the fact that the patient had consulted me for similar complaints some 20 years earlier when I was in general practice.
Mr. R was a middle-aged married man, father of two children, working in a responsible administrative position at the time he contacted me for an appointment. He was self-referred. He reminded me that he had been my patient 20 years earlier, when I was in