ABSTRACT

We present our work as psychoanalysts in the interdisciplinary psychosomatic unit of a paediatric hospital. As the starting point for our work we use Winnicott’s understanding of the psychosomatic dilemma delineated in his paper on psychosomatic illness in its positive and negative aspects. The central hypothesis is that splitting the medical field into many highly specialized fields can be understood as a display of the psychosomatic patients’ inner need for splitting and their defence against integration. Based on four case examples from different developmental periods, we demonstrate the interconnectedness of the relational environment, developmental processes, and psychic and biological conditions, and show how early experiences of threat and deprivation can cause the soma–psyche unit to fragment. Drawing on several psychoanalytic psychosomatic schools, we delineate treatment principles of the psychoanalytic contribution to the interdisciplinary work and of the individual psychoanalytic treatment.

摘要

我们在一家儿科医院的跨学科心身病房介绍我们作为精神分析师的工作。作为我们工作的起点，我们使用温尼科特对心身困境的理解，在他关于心身疾病的正面和负面方面的论文中描述。中心假设是将医学领域拆分为许多高度专业化的领域可以理解为心身患者对分裂的内在需求和他们对整合的防御的展示。基于来自不同发展时期的四个案例，我们展示了关系环境、发展过程以及心理和生物条件之间的相互联系，并展示了威胁和剥夺的早期经历如何导致躯体 - 心理单元分裂。