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On a Soma-Psychotic Part of the Personality: a Clinical and Theoretical Approach to the Somatic

Inspired by Bion, the concept of a soma-psychotic part of the personality is suggested. The authors present four clinical vignettes to illustrate certain clinical phenomena in which the body played a key role in the patient’s personal history, during the analytic process, or both. Certain aspects of analytic technique with these severely disturbed patients are briefly referred to, including the analyst’s reverie and transformational capacity, and some observations made in these cases lead to tentative generalizations on mental functioning and psychosomatic unity. A theoretical model is constructed to contain both data and conclusions, and to offer a solution for the integration of the somatic in psychoanalytic theory.