Review of the Somatic Response: Formation in Child Development

A charming five year old boy was undergoing psychotherapeutic treatment owing to restlessness and lack of independence. In addition, he suffered from epilepsy, which began at the age of three. Since this time the boy had periodically fallen into epileptic states which could last almost a day. Conventional medicine alleviated the intensity of the fits, but did not prevent them from recurring. His parents sought help from an osteopathic physician, and after two years of treatment the frequency of the fits decreased to once or twice a month, and the fits manifested only as tongue clicking after which the boy fell asleep. After an additional year of psychotherapy this somatic response ceased as well, and has not returned.

A nine year old girl, who looked her age, spoke on a three or four year old level. She suffered enuresis and occasional encopresis.

A seven year old boy had an exceptionally unfavorable destiny because he had had surgery as an infant. Then, there were surgeries at three, five, and seven years. The last surgical intervention was undertaken due to an intestinal obstruction complicated by severe vascular and renal disease.

A very lovely, cheerful five year old girl had a genetic illness, which had been diagnosed in infancy. She frequently suffered illnesses accompanied by high fevers, and a cough that frightened all the doctors.

All of the children presented above are psychotherapeutic patients. These are only four examples of my patients from 5 to 9 years of age, who suffered somatic illnesses in addition to psychological manifestations of their problems. In this paper I would like to draw the attention of the psychotherapists to the somatic manifestations of the various conditions of poor health, that are exceptionally widely presented in children, as well as in adults. It is very often the case that specialists, who work in a field of human psychology, demonstrate indulgent concern to somatic symptoms, while doctors who deal with somatic disorders hardly pay any attention to the psychological problems. The history of psychoanalysis shows that due to the special circumstances of the period when psychoanalysis began, Sigmund Freud intentionally divided the somatic and psychological, and only thanks to this it became possible to evolve psychoanalysis any further.

Sixty years have passed since the last of Freud's papers was written, but it is only in the last decade that our country discovered psychoanalysis. It was cultural tradition that psychologists were scared of somatic symptoms. When they found "organic" manifestations, they ceased their work and sent the patient to allopathic physicians. To study only psychological symptoms, and to ignore somatic symptoms can be characterized as one-sided perception and will lead to the loss of the whole picture of a man. Today we witness the progressive separation of the psychological and the somatic, which tear the human being in pieces, in spite of deepening of investigations in both fields.

The last decades have been rich with scientific observation and with studies of newborns. In this paper I would like to focus your attention on the initial formation of somatic responses, which in consequence will manifest in various diseases. Revealing the psychological accompaniment of the somatic component necessitates the engagement of the psychologist with treatment of somatic illness.

Every psychotherapist who works with adult patients regularly meets with patient's complaints about some somatic disorder. The psychotherapist makes an attempt to understand what the patient tells him. From the allopathic viewpoint, the symptoms represent the manifestation of disease, which necessitates treatment. From the psychoanalytic viewpoint, the symptoms represent compromise formation, which introduces a manifestation of internal conflict. Is it really true that, having referred the patient to the allopathic physician, the psychotherapist hopes that medicine will resolve this conflict? The question is, could this explain the increase in the use of tranquilizers? Why is it that the somatic response is appearing more frequently?

Anna Freud, in 1974, wrote: ". . . during the first year of life, while psychological life expands, there is an access between the body and the soul. Every somatic change is followed by mental torture, tears and so on, while every psychical...