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A Psychodynamic View of Psychosomatic Medicine

Address reprint requests to: John C. Nemiah, MD, 4 Rayton Road, Hanover, NH 09755-2214.

OBJECTIVE: The objective of this article is to assess the relevance of psychodynamic observations and theory for psychosomatic medicine.

METHODS: The evolution of the psychodynamic formulation of psychosomatic symptom formation is described in a brief historical review.

RESULTS: There are two distinctly different pathways along which stress-induced psychological arousal is transformed into somatic symptoms.

CONCLUSIONS: Psychodynamic observations and theory have important implications for psychosomatic research and treatment.

Key Words: alexithymia • conversion • dissociation • egodeficit • psychodynamic conflict

Abbreviations: DSM = Diagnostic and Statistical Manual of Mental Disorders.

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