The work of hypochondria. A contribution to the study of the specificity of hypochondria, in particular in relation to hysterical conversion and organic disease.

The authors present a metapsychological conception of hypochondria. Following Freud, they contrast the complaints of the hypochondriac with the belle indifférence of the hysteric, and they then inquire into the heuristic value of hypochondria as an actual neurosis; this leads them to a consideration of psychosomatic illness and the importance of the object cathexis in hypochondriacal anxiety. In the development of Freud's theory of the drives, the explanatory concept of the damming up of ego libido proves insufficient and has to be coupled with the notion of primary erotogenic masochism: from this point of view, hypochondria can be seen as a form of binding which thus distinguishes it from other somatic outcomes. On the basis of three case histories, the authors endeavour to show hypochondriacal anxiety not only as a pathological process but also as a type of necessary minimum cathexis of the body; this leads to the idea of hypochondria as psychical work.