Department of Paediatric Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Medical Center, Leipzig, Germany.
Int J Psychoanal. 2021 Feb;102(1):91-108. doi: 10.1080/00207578.2020.1858084.
We present our work as psychoanalysts in the interdisciplinary psychosomatic unit of a paediatric hospital. As the starting point for our work we use Winnicott's understanding of the psychosomatic dilemma delineated in his paper on psychosomatic illness in its positive and negative aspects. The central hypothesis is that splitting the medical field into many highly specialized fields can be understood as a display of the psychosomatic patients' inner need for splitting and their defence against integration. Based on four case examples from different developmental periods, we demonstrate the interconnectedness of the relational environment, developmental processes, and psychic and biological conditions, and show how early experiences of threat and deprivation can cause the soma-psyche unit to fragment. Drawing on several psychoanalytic psychosomatic schools, we delineate treatment principles of the psychoanalytic contribution to the interdisciplinary work and of the individual psychoanalytic treatment.
我们作为精神分析师在一家儿童医院的跨学科身心医学科工作。我们的工作以温尼科特在其关于身心疾病的积极和消极方面的论文中阐述的身心困境为出发点。中心假设是，将医学领域划分为许多高度专业化的领域，可以被理解为身心患者内心分裂的需求和对整合的防御的表现。基于来自不同发展阶段的四个案例，我们展示了关系环境、发展过程以及心理和生理条件的相互联系，并展示了早期的威胁和剥夺经历如何导致躯体-心理单位的分裂。借鉴几个精神分析身心医学学派，我们描述了精神分析对跨学科工作的贡献以及个体精神分析治疗的治疗原则。
