Hypochondria as a self-destructive attack on the subject’s vitality^*

* Translated by Philip Slotkin MA Cantab.

Click to increase image sizeClick to decrease image size

Notes

* Translated by Philip Slotkin MA Cantab.

1 See the perspicuous discussion by the philosopher Langer (1942).

2 On the hysteric's triangular use of the body, see Rupprecht-Schampera (1995).

3 Cf. Stern’s (1985) concept of “vitality affects,” which denotes the dynamic aspects of the expression of affects. Vitality affects are significant elements in the processes of attunement between mother and child, and make for the experience of an emergent self and the emergent other.

4 Cf. Bollas’s (1992) concept of “self dissemination.”

5 Cf. Rangell’s (1959) argument that conversions are encountered not only in hysteria (where they are, of course, cardinal symptoms), but also in other clinical pictures. Hypochondria is a good example, because it uses conversion as the starting point for the development of anxiety, whereas hysteria introduces conversion to the dyadic relationship triumphantly and combatively, while protecting the self.

6 See Freud's comment on the ‘diagnostic ability of a dream to sense incipient physical pathology on a hypochondriacally magnified scale: “[…] all psychical cathexes [are withdrawn] from the external world back on to the ego, and it [a dream] makes possible early recognition of bodily changes which in waking life would still for a time have remained unobserved”’ (1917, 222; as quoted by Nissen 2015, 18 [Nissen's words translated]).

7 A full discussion can be found in my first contribution on the subject (Rupprecht-Schampera 2003).

8 The term and the concept are due to Fairbairn (1941, 56).

9 Put briefly, the child must see himself as “bad” and as the cause of the object's rejection, in order to preserve the conception of the object as good and idealizable.