ABSTRACT
This short chapter presents an object relations formulation of the unconscious meaning of somatic symptomology in depression.
Depression often presents as a psychosomatic crisis. The physical suffering and immobilization of the body ± its systems and its organs ± are well documented as a way in which depression manifests itself, and indeed presents itself for treatment, particularly in hypochondria. Freud (1917, p. 253) himself pointed out an important somatic factor in noticing how the melancholic's mood lifts towards evening time ± one of the ®rst references to the analytic literature to the circadian shape of depression. How are these invasive symptoms, that invariably take a vegetative and psychomotor form, to be understood analytically? In Chapter 4 it was claimed that the classic bodily symptoms of depression are associated with the deepest level of the mind, namely, the object relations con¯icts belonging to the paranoid-schizoid position. That is to say, the body is the principal site of suffering because the ego is not yet suf®ciently advanced to fully absorb bodily excitation and tension. I also suggested that where con¯icts between the ego and superego are a signi®cant factor in depression symptoms express themselves mainly through mental impairments.
