Journal of Psychosomatic Research 52 (2002) 371
Plenary Lecture 2, 22.06.02, 11:00–12:00 340 SOMATIZATION AND CONVERSION: A PSYCHOANALYTIC PERSPECTIV...
Plenary Lecture 2, 22.06.02, 11:00–12:00 340 SOMATIZATION AND CONVERSION: A PSYCHOANALYTIC PERSPECTIVE Taylor GJ. Although the clinical features of somatization disorder and conversion disorder are defined clearly in the DSM-N classification of psychiatric disorders, there is frequent confusion over the pathological processes that are presumed to underlie the somatic symptoms associated with these disorders. This confusion is not confined to the fields of psychiatry and psychosomatic medicine, but is present also in psychoanalysis where the concepts of somatization and conversion originated. In recent years some medical historians have also misunderstood these concepts and used them interchangeably to argue that all medically unexplained symptoms are produced by the action of the unconscious mind. In addition, several researchers have made a strong case for reconceptualizing somatization (and also hypochondriasis) as a dimensional construct rather than a categorical entity. This paper will attempt to relieve some of this confusion by reviewing the various conceptualizations of conversion and somatization that have been proposed by psychoanalysis over the past century. The influence of these conceptualizations on psychosomatic theory and therapy will also be discussed. Whereas some psychoanalysts adopted Stekel’s view that somatization involves a psychological process analogous to conversion, others maintained Freud’s distinction between the psychoneuroses and the actual neuroses and viewed somatization as a physiological process. Recent psychoanalytic attempts to understand somatization are based on a modem theory of emotional processing which is rooted in cognitive science and open to
empirical research. Clinical examples will be presented to illustrate the different psychoanalytic perspectives.
360 RECENT DEVELOPMENTS IN RORSCHACH ASSESSMENT Weiner I. The Rorschach Inkblot Method is a measure of personality functioning. Rorschach findings provide considerable information about what people are like and how they are likely to behave, particularly with respect to how they pay attention to their surroundings, use ideation, process affect, manage stress, view themselves, and relate to other people. For this reason, Rorschach assessment has become widely used in recent years not only in its traditional clinical applications, but also in health care, forensic, educational, organizational, and other settings in which decisions about people are based in part on their personality characteristics. This presentation will review these developments in Rorschach applications and also identify three other advances in knowledge about the Rorschach method: (a) the availability of meta-analytic data validating the psychometric soundness of Rorschach variables in correlating with external criteria, especially long-term behavioral dispositions; (b) the emergence of cross-cultural normative studies demonstrating the universal applicability of the Rorschach method and the types of interpretive adjustments that are nevertheless required in different countries; and (c) increased awareness of the manner in which Rorschach assessment can be integrated within self-report inventories to increase the validity and utility of a test battery.
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