When the body speaks: A case discussion of bodily manifestations of introjection and identification with the aggressor

Abstract

This paper provides an analysis of the patient’s somatic experiences and fantasies during the psychoanalytic psychotherapy of childhood relational trauma. Somatizations and enactments pertaining to childhood traumas are discussed as they expressed aspects of early stigmatizations, social bullying, and parental boundary violations. A central persecutory theme of impending death during the Covid pandemic is discussed as it revealed previously unspeakable persecutory fears. Obsessional somatic preoccupations and fantasies expressed the patient’s sense of inescapable condemnation and annihilation, which in turn portrayed the patient’s fear of parental homicidal wishes toward the patient. Key aspects of this treatment also concerned an analysis of self-endangerment and suicidality as a defensive process of identification with the aggressor. Somatic aspects of transference and countertransference phenomena are explored as an integral part of the analysis. A discussion of the case material with two psychoanalyst colleagues is included.

Key words:

• somatization
• somatic transference
• somatic countertransference
• enactment
• relational trauma
• intersubjective
• Covid
• psychosomatic
• transformational object
• stigmatization

Disclosure statement

No conflict of interest to report on behalf of authors.

Patient Anonymization

Potentially personally identifying information presented in this article relates directly or indirectly to an individual, or individuals, has been changed to disguise and safeguard the confidentiality, privacy and data protection rights of those concerned.

Additional information

Notes on contributors

Ernesto Mujica

Ernesto Mujica, PhD, is a supervisor of psychotherapy at the William Alanson White Institute, New York, USA, where he is an Associate Editor of the Institute’s journal, Contemporary Psychoanalysis, and serves as director of the Institute’s Sexual Abuse Study Group and Service. Dr. Mujica has served as president of the Division of Psychoanalysis for the New York State Psychological Association and also served on the Board of the Division of Psychoanalysis (Division 39) of the American Psychological Association. He is a member of the American Psychological Association Division 39, American Psychoanalytic Association, International Association of Relational Psychoanalysis and Psychotherapy, International Federation of Psychoanalytic Societies, and International Psychoanalytical Association . E-mail: [email protected].

June Her

June Her, MDiv, is executive director of the Institute for Clinical Psychoanalysis in Seoul, South Korea, where he also serves as training analyst and as teaching and supervising faculty. He maintains his private practice for psychoanalysis and psychotherapy with adults in Seoul. He is a member of the International Association of Relational Psychoanalysis and Psychotherapy, an International Member of the American Psychological Association Division 39, and a member of the Korean Society of Clinical Psychoanalysis. E-mail: [email protected].

Hyun Ah Lee

Hyun Ah Lee, MA, is associate director of the Institute for Clinical Psychoanalysis in Seoul, Korea, where she also serves as a training analyst and teaching and supervising faculty. She maintains her private practice in psychoanalysis and psychotherapy with adults in Seoul, with her main interests in the treatment of anxiety and panic disorder, depression, gender issues, and somatization. She is a member of the International Association of Relational Psychoanalysis and Psychotherapy, an international member of the American Psychological Association Division 39, and a member of the Korean Society of Clinical Psychoanalysis. E-mail: [email protected].