Hypochondrias, somatic delusion and body scheme in psychoanalytic practice.

One of the objectives of this paper is to differentiate between various types of hypochondria. Phenomenic, dynamic and clinical aspects are specially emphasized and a case of somatic delusion is presented. The author attempts to explain the dynamic mechanism on which each type of the different hypochondrias is based in order to facilitate the technical work. The different fantasies about the body scheme underlying each type of hypochondria are described. Hypochondria related to a primitive conception of Body Image, where ego disorganization-fragmentation or ego liquefaction can be expressed as spilt of vital liquids or blood. The conceptualization of hypochondria based on autistic mechanisms can help to explain certain clinical presentations of encapsulated hypochondrias which have been silent for a long time. We therefore consider it is useful to widen the spectrum of hypochondria: every type of hypochondria has a different fantasy about the Body Image.