Body and mind: two sides of one coin

ABSTRACT

Psychosomatics is concerned with mentalization and the mind’s impact on the body’s functions. Choosing the reverse approach, how the body steers the mind, the author elaborates on a monistic mind-body-theory, suggesting that all physiological processes down to the cellular level have a psychological concomitant. Body and mind are the two sides of one coin, distinguished though by different representational organizations. This perspective is pertinent to Freud’s 1915 definition of the drive as the body’s demand on the mind. It also opens interesting perspectives for the elaboration of a preservative drive and its specific ideation in mental life. Comparing the dynamics between the sexual and the preservative drives with the workings of the autonomous nervous system reveals some specific traits of the preservative drives, as they are considered characteristic for psychosomatic patients. As a case in point, the author looks into the French conception of the drives and the theoretical framework of the Paris School of Psychosomatics, to which her conception would add an important dimension, theoretically, clinically, and technically.

KEYWORDS:

• Metapsychology
• drive theory
• self- and object-preservation
• psychosomatics

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. I’ve suggested to add a system Pre-Ucs to the topographic model, analogue to the Pre-Cs as the precursor of the Cs. (Schmidt-Hellerau, 2001, 162ff.) I conceptualize the pre-unconscious as psychic; hence it is not identical with what Green criticizes Marty of, namely his ‘hypothesis of a prepsychic as a somatic sphere’ or ‘a “fore-psychic” (avant-psychique).’ (Green, 2010, p. 2ff.)

2. Freud (1893) points out that ‘Hysteria is ignorant of the distribution of the nerves, and that is why it does not simulate periphero-spinal or projection paralyses. It has no knowledge of the optic chiasma, and consequently it does not produce hemianopsia. It takes the organs in the ordinary, popular sense of the names they bear: the leg is the leg as far up as its insertion into the hip, the arm is the upper limb as it is visible under the clothing. There is no reason for adding paralysis of the face to paralysis of the arm.’ (p. 169) See also Schmidt-Hellerau (2002).

3. Green’s argument is more poetic than compelling: ‘The stimuli, as such, are unknowable, have no direct psychical expression. They are of an absolutely natural order, but they are not fixed. They make their way to the psyche – and it is on arrival, as if crossing a frontier, that they become psychical representatives, delegates or ambassadors in another country. The drive, then, is the result of a journey that ends in “psychization”. The drive, its motive force, is that invitation to a journey. But the passengers, the stimuli, are not, on arrival, in the same condition that they were at their departure. Just as ambassadors often adopt the way of life, even in the appearance, of persons of the country to which they have been sent, so the stimuli born in the organism disguise themselves in forms proper to psychical activity. But they remain representatives of those stimuli. In any case, the change from the organic to the psychical only occurs at the crossing of a frontier. The drive is not so much a place as a circuit.’ (Green, 1999, p. 169).

4. In my conception the term mentalization would not refer to something somatic getting mental representation, but simply to the growing complexity and organization of mental elements from their lowest to their highest level of functioning.

5. ‘J’ai insisté, j’y reviens encore, sur le fait que l’autoconservation se trouve expulsée de cette théorie … je dirai que l’auto-conservation (l’instinct), dans la vie de chacun d’entre nous, est “mise sur la touche”, disqualifiée, exactement comme l’autoconservation est mise à l’écart, dans le mouvement de la pensée freudienne, après 1915. Je parle ici d’instinct au sens précis, c’est-à-dire par opposition au drive.’ (Laplanche, 1997, p. 153).

6. A selection of my papers on these issues can be found in my book, Schmidt-Hellerau, Driven to Survive (2018).

7. Meerwein, Kauf, and Schneider (1976), who worked with terminally ill cancer patients, reflected on the splits in dying patients: one day they were planning a trip around the world or starting a new company, the next day they had given up all hope and thought of nothing but dying – both in quick and repeated alternation. As they noted, these mood shifts are difficult to tolerate and respond to. In the context of this paper, they seem to indicate a dissolution of the life and the death drives’ dynamic interaction.

8. Velasquesz-Manoff (2012) suggests that auto-immune diseases reflect an immune system lacking the work it has been cut out for in its evolution. Our genetic inheritance cannot adapt fast enough to a now hyper-hygienic environment; thus the immune system attacks its own cells for lack of alien others. The development of cancer treatments, which enlists the patient’s own immune system, e.g., by guiding it with an inactivated polio-virus, seems to make use of a similar line of thought.

9. Also, the dreamless sleep would be predominantly lethic, while the dreaming periods of the REM-sleep would involve libidinal activities.

Additional information

Notes on contributors

Cordelia Schmidt-Hellerau

Training and Supervising Analyst of the Swiss Psychoanalytic Society and The Boston Psychoanalytic Society and Institute, Chair of the IPA in Culture Committee, Practice in Chestnut Hill, MA, USA