ABSTRACT
The most primary form of caretaking of the mother is a combination of the physical and the psychic-emotional aspects. Winnicott (1949) makes clear that the good enough (maternal) environment is one that “makes active adaptation to primitive needs” (p. 246). The baby’s ability to be, what Winnicott refers to as “continuity of being,” depends on her/his mother’s ability to provide an environment that suits the baby’s needs. This requires a maternal presence that is attentive to the baby. If the mother’s presence is deficient or too excessive and over-stimulating (as in the case of anxious mothers) the infant is required to react to this. One of the short- and long-term consequences may be psychosomatic illness, as a manifestation of the tears the infant has experienced in the mother–infant unit.
In this chapter, I will offer a view of psychosomatic symptoms as experiential phenomena that function as “physical dreams,” either as “undreamt” dreams or as “interrupted” dreams (Ogden, 2004a, 2004b). I will reflect on how patients can utilize their symptoms in undertaking unconscious psychological work. For this work to be carried out, patients and their analysts need to have some ability to engage in intersubjective “dream-work” with the patient's symptomatology. In the tradition of Bion’s (1962a, 1962b) conception of the contact–barrier’s dual function, I propose viewing psychosomatic symptoms as constructions by which aspects of the psyche–soma are rendered conscious or unconscious in the service of psychological work. With the analyst’s aid, the analysand may restart his or her interrupted “physical” dreaming and/or (re)form an “undreamt” dream, transferring and transforming “physical” into “psychical” material and verse versa.
