Fig. 7.1
Underlying dynamic situation in the Schreber case
Fig. 7.2
Underlying dynamic situation in the case of failure of character functioning
As paranoia, psychosomatic disorder that must be understood as an episode in a development in which projection that works as dream holds the Real body away from somatizations, hypochondria, as of projective essence, perfectly illustrates the negative correlation that we mentioned, projection having a biological value. Such an observation in appearance harmoniously agrees with the Freudian idea of a kind of perfect narcissistic equivalence between hypochondria and somatic disease, in a purely economic perspective. Our point of view however differs. If, in three reported cases out of four, somatic complaint seems to begin immediately after an allergic problem, if according to doctors negative reports often have a morbid organic fate, an equivalence can be established between these different sets of symptoms, but this equivalence is given as negative: psychosis succeeds where allergy fails, projective exhaustion opens on organic expression. “Psychic” and “somatic” occur here as two strictly symmetrical positions: equipped with a same symptomatic coefficient, organic affection appears in lieu of any neurotic, psychotic formation. This phenomenon, far from “somatic complacency,” however which tends to show that, far from being a purely psychological mechanism, projection is always accompanied by a strengthening of the immune system which, conversely, come to weaken when the projective process fades. The same thought process that led Freud to see hypochondria as little elaborated thus also led him to misjudge how symptomatic healing worked: in his system, a theory of the body is missing, of which projection is an inseparable feature. Schreber’s delusions, as they grow, are accompanied as well by the same process, causing the spontaneous disappearance of an allergic rhinitis in conjunction with a resistance so exceptional that Schreber can feel “immortal.” This shows that what we have here is not the elaboration of hypochondria, as argued by Freud, but a situation of impassable impasse, where somatization in the Real body constitutes the other term of the alternative.
7.3 The Limited Development of an Impasse
Once its projective nature, and then its positive link to the Imaginary, have been identified, hypochondria in a way acquires a metapsychological basis as it operatively very concretely involves, in clinical practice, a typical symptomatic variability where “Psychic” absorbs and changes “Somatic.” Observation here tends to go beyond it, revealing the profound unity of the phenomenon whose definition can be articulated around several proposals. We will only present some of them, derived from the dynamic situation underlying the four previously narrated clinical cases (see Fig. 7.3), so that they can be viewed, described, interpreted through a relevant replacement procedure. The following remarks apply:
