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When the Body Displaces the Mind: Stress, Trauma and Somatic Disease PDF

215 Pages·2007·1.217 MB·English
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Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page i WHEN THE BODY DISPLACES THE MIND Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page ii Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page iii WHEN THE BODY DISPLACES THE MIND STRESS, TRAUMA AND SOMATIC DISEASE Jean Benjamin Stora Foreword by Mark Solms Translated by Sophie Leighton Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page iv First published in 2007 by Karnac Books Ltd. 118 Finchley Road, London NW3 5HT Copyright © 2007 by Jean Benjamin Stora English language copyright © Sophie Leighton 2007 The rights of Jean Benjamin Storato be identified as the author of this work have been asserted in accordance with §§ 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. British Library Cataloguing in Publication Data AC.I.P. for this book is available from the British Library ISBN-13: 978-1-85575-418-8 Typeset by Vikatan Publishing Solutions, Chennai, India Printed in Great Britain www.karnacbooks.com Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page v CONTENTS FOREWORD ix Mark Solms ACKNOWLEDGEMENTS xi Introduction 1 1 Emotions and traumas 9 2 The economic viewpoint and mentalisation processes 27 3 Amanda, Arnaud, Alice, Sandrine and Emma– somatisations and regressions 55 4 Adrienne and Sanjay–progressive disorganisation and somatisations: the emergence of irreversible unstable equilibria 87 5 The psychotherapy of somatic patients– the case of Nina, a woman from the Maghreb 125 v Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page vi vi CONTENTS APPENDICES 173 NOTES 181 BIBLIOGRAPHY 185 INDEX 197 Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page vii For Judith and Michael Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page viii Stora-When the Body_FM.qxp 5/21/07 7:57 PM Page ix FOREWORD The boundaries between disciplines have recently been seriously challenged in the neurosciences. This has resulted, among other things, in a realisation that the brain cannot be understood in isola- tion from other bodily organs. This realisation, in turn, has produced important advances in neuro-endocrinology and neuro-immunology, to mention only the obvious instances. But certainly one of the most significant advances brought about by this development has been in the scientific understanding of emotion. Few neuroscientists today would deny that the brain mechanisms of emotion (and drive) are centrally embedded in brain: body relationships. According to the currently dominant view, emotions are concep- tualised as evaluative neural registrations of the visceral body’s cur- rent state. This conceptualisation reflects the truism (all too easily forgotten) that the essential function of the brain is to represent the state of the body – of both its sensory end-organs and its endoge- nous visceral detectors – and then, drawing on past experience, to ‘compute’ appropriate efferent responses to this state. These efferent responses, no less than the inputs that trigger them, are of two types: both external and internal. In the latter (internal) responses we find the common origin of many (if not most) of the complex phenomena that are grouped together clinically under the heading of ‘psychoso- matic medicine’. It is very much to the credit of contemporary neuroscience that it has found a place for psychoanalysis in this interdisciplinary vortex, and it is likewise fortunate indeed that psychoanalysis (under the banner of ‘neuro-psychoanalysis’) has been able to rise to the occa- sion, and make some significant contributions to the avalanche of neuroscientific discoveries that are now reported almost daily. These ix

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