Experiences of and responses to bodily symptoms have long held interest, from earlier roots in hysteria to the most recent category of somatic symptom disorder (SSD) in DSM 5. SSD’s focus on distress implies that symptoms hold meaning for individuals. This study used a psychoanalytically-informed, multiple interview method and analysis to explore such possible meanings. Six participants were interviewed on three occasions each, with four themes emerging as follows: (1) a foreign body in charge; (2) left alone with the foreign body; (3) the body works for the mind; and (4) the body mirrors the mind. Bion’s idea of an active container-contained function and the construct of psychic pain formed a useful framework for understanding themes. The distress that lies in somatic symptoms was formulated as potentially stemming from an initial difficulty with containment in the primary object relationship. It is argued that distress may indicate a struggle with suffering that is not only somatic but also psychological in nature; and that the symptomatic body may have reached its limits in containing psychic pain. Implications for working clinically include the importance of close and sustained attention, through the clinician’s reverie, to somatic and emotional feeling states to help guide treatment.

中文翻译：

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撕裂或爆裂或难以忍受的东西：对躯体症状的心理分析知情探索

从歇斯底里的早期根源到DSM 5中最新的躯体症状障碍（SSD）类别，人们对身体症状的经历和反应一直引起人们的关注，SSD专注于痛苦意味着症状对个人具有意义。这项研究使用了一种经过心理分析的多面谈方法和分析来探索这种可能的含义。六次与会人员分别接受了三次采访，出现了以下四个主题：（1）负责外国事务的机构；（2）留在异物上；（3）身体为头脑工作；（4）身体是心灵的镜像。Bion提出了一种主动的容器功能和精神痛苦的构想，为理解主题提供了有用的框架。存在于躯体症状中的困扰被表述为潜在的起因于最初对主要客体关系的控制难以解决。有人认为，苦难可能表明与苦难的斗争不仅是身体上的，而且是心理上的；有症状的身体在控制精神痛苦方面可能已达到极限。临床工作的意义包括通过临床医生的遐想密切和持续关注对躯体和情绪状态的重要性，以帮助指导治疗。