Coniunctio - in bodily and psychic modes: Dissociation, devitalization and integration in a case of chronic fatigue syndrome

Journal/Book: J Anal Psychol. 1997; 42: 11 New Fetter Lane, London, England EC4P 4EE. Routledge. 217-236.

Abstract: Three years of analytical psychotherapy with a professional woman in midlife, suffering from chronic fatigue syndrome (CFS), is described. Gradual recovery merged into mid-life changes; marriage, along with a new balance of maternal and paternal images, enabled her to trust enough to become pregnant-coniunctio in the most primal bodily and psychic modes. Her life-long, schizoid type pattern, 'the pendulum of closeness and isolation', with its extreme of psyche-physical collapse and devitalization, was replayed in therapy. The analyst's symbolic attitude is emphasized, containing the patient's initial affective explosion and validating the physicality of her condition. Mirroring and steady rhythmic attunement became a new, pre-verbal, source of trust-vitalization; differentiation and separation replaced defensive splitting and dissociation. Then the overwhelmingly powerful bodily/ maternal could be counterbalanced by the masculine, and a transitional space emerged for symbolic work. Both the regressive and the dynamic aspects of CFS are located in the earliest undifferentiated, archetypal, bodily/psychic modes, when the frustration of primary needs evokes the defences of the self. It is argued that our psychodynamic under standing can contribute to the stalemate in seeing chronic fatigue syndrome as either an organic illness or depression, and that a new linking of the somatic and psychic calls for a new professional collaboration.

Note: Article Holland P, 16 Calton Hall, Edinburgh EH1 3BJ, Midlothian, SCOTLAND

Keyword(s): chronic fatigue syndrome (CFS); myalgic encephalomyelitis (ME); devitalization; schizoid states; coniunctio; Guntrip; OBJECT RELATIONS; BODY

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