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Bodily & psychic modes: dissociation, devitalization & integration in a case of Chronic Fatigue Syndrome (CFS)

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By Holland P • www.ProHealth.com • April 12, 1997


Three years of analytical psychotherapy with a professional woman in
mid-life, suffering from chronic fatigue syndrome (CFS), is
described. Gradual recovery merged into mid-life changes;
marriage, along with a new balance of maternal and paternal
imagos, enabled her to trust enough to become
pregnant-coniunctio in the most primal bodily and psychic
modes. Her life-long, schizoid type pattern, "the pendulum of
closeness and isolation', with its extreme of psycho-physical
collapse and devitalization, was replayed in therapy. The
analyst's symbolic attitude is emphasized, containing the
patient's initial affective explosion and validating the
physicality of her condition. Mirroring and steady rhythmic
attunement became a new, pre-verbal, source of
trust-vitalization; differentiation and separation replaced
defensive splitting and dissociation. Then the overwhelmingly
powerful bodily/maternal could be counterbalanced by the
masculine, and a transitional space emerged for symbolic work.
Both the regressive and the dynamic aspects of CFS are located
in the earliest undifferentiated, archetypal, bodily/psychic
modes, when the frustration of primary needs evokes the
defences of the self. It is argued that our psychodynamic
understanding can contribute to the stalemate in seeing
chronic fatigue syndrome as either an organic illness or
depression, and that a new linking of the somatic and psychic
calls for a new professional collaboration.




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