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Through a thorough reading of Freud's hysteria cases, Iréne Matthis gives a model for the understanding of today's mute sufferings; sufferings hidden behind the diagnoses of fibromyalgia, different sorts of muscle pains, etc. Her main thesis is that much of this suffering is due to a deformation of the symbolising process, a deformation through which the body has become the “scene” for wordless dramas of traumas, conflicts and suppression. Through the “word” (as may be spoken by the psychoanalyst, the doctor, the patient, or someone else), what she calls a protosymbol (e.g., the bodily pain) may be set in motion. This protosymbolic motion reaches a fullness in a symbolic working through which is a part of the chatartic representational work which cleans and heals.
This is, in two respects a remarkable book; it is one of the few psychoanalytic doctoral dissertations delivered in Scandinavia in recent years, and, because of this, it is written in a language free from psychoanalytic jargon. Every concept is introduced systematically and pedagogically, building a coherent presentation of a difficult theme that is acutely important for today's health care.
Necessary in today's rationalised health-care system, the question could be put quite simply and naively: “should we take time to listen to our patients?”. Of course, this is what we, as psychoanalysts, do. But it is not obvious in somatic medicine, and even not in the busy psychiatric services where severely ill patients often do not get more than three or four sessions at the psychiatric out-patient clinics.
Apart from being a psychoanalytic scientific dissertation, this work has also a serious health-political aim. The growth of ill-defined illnesses, with