Psychoanalytic observations on vulnerability to physical disease.

Abstract

The psychological indicators discussed in this paper are not per se predictors of physical illness; yet they represent specific genetic-dynamic forces and occur too frequently to be coincidental and of no significance. Rather, they are warning cues to vulnerability to somatic illness and supplementary to the risk factors derived from physical data. The list of vulnerability cues includes exposure to stress. This is an alerting cue; past modes of reaction to stress in the form of physical patterns (but not conversion reactions); regressive shifts of defenses in the direction of resomatization; mounting aggression that is not directly verbalized; diminution of psychologically expressed guilt, though guilt would be expected and indeed becomes manifest in physical form; psychological versions of transference reactions replaced by expressions in body language; dreams in which stimuli from early physical dysfunction are recurrently part of the daily residue and give a somatic cast to current conflicts; identification with important objects that is increasingly expressed in somatic terms. These cues tend to be accompanied by a growing perception of, and preoccupation with, the body. The more such indicators are present and noted, the greater their usefulness in predicting physical illness.