Les relations corps esprit ou la Psychosomatique Intégrative
Les relations corps esprit ou la Psychosomatique Intégrative
Pr Jean Benjamin STORA psychosomaticien des relations corps-esprit, mieux soigner les maladies somatiques
Pr Jean Benjamin STORA psychosomaticien des relations corps-esprit, mieux soigner les maladies somatiques
comment mieux soigner les patients somatiques
ECOLE PSYCHOSOMATIQUE DE LA PITIÉ-SALPÊTRIÈRE comment mieux soigner les patients somatiques

When the body displaces the mind Karnac ed.

When the Body Displaces the Mind : Stress , Trauma and Somatic Disease
by Stora, Jean Benjamin.

This work by Professor Jean Benjamin Stora presents a new approach to body-mind relations with a view to achieving better understanding and therefore better treatment of patients suffering from somatic diseases.

A psychoanalyst and psychosomatician, head of teaching for Integrative Psychosomatics at the Faculty of Medicine at La Pitié-Salpêtrière (Paris), he resituates the psychic system - the mind - in the individual psychosomatic unity and emphasises its relation to the central nervous system and all the somatic functions and organs. He postulates the existence of somatopsychic organisations throughout the process of psychosexual development, thus supplementing in the somatic domain the developmental stages (oral, anal, phallic and genital) proposed by Sigmund Freud to make these into comprehensive organisations that are no longer restricted to the psychic apparatus. Thus the psyche is no longer separated from the body, and the body-mind dichotomy is removed, giving way to a continual process of integration of the psyche, the organic functions and the central nervous system, which occurs during the first twenty years of life in human beings.

In the context of this new approach, it is no longer a question of psychosomatic diseases but the role that the psyche plays in all diseases without actually being their cause. The psyche participates in the defence of both the organism and the immune system and it must be examined in relation to the somatic functions and organs.

The principal role of the psychic apparatus is to manage the quantum of excitations - a work of elaboration - that assail a human being in his daily life; now, this psychic apparatus can be overwhelmed by excitations either momentarily or for longer periods of time, undermining the individual's mental defences. This can result from stress in daily life or traumas (mourning close family members, a dismissal, accidents etc.). If the stress or the trauma continues over a long period, this leads to a disconnection within the psychosomatic unity and the implementation of biological somatisation processes that are currently explained by neuropsychoanalysis, psychoneuroimmunology or psychoneuroendocrinology. Today we have a better understanding of somatisation processes.

The Paris School of Psychosomatics established by Pierre Marty, of which Jean Benjamin Stora was president from 1989 to 1992, has studied (works by Marty) the psychic malfunctionings and anomalies in mental functioning that foster psychosomatic regressions and disorganisations.

When the human being is overwhelmed by excitations, tensions and frustrations, and the psychic apparatus is no longer able to absorb them because of its fragility and its weaknesses, it is the body that takes over.

This book is illustrated by many clinical cases that give us a better understanding of the diagnostics and the therapeutic strategies that are needed to combine medical treatments and psychosomatic psychotherapies; the final chapter addresses the problem of patients with a history of immigration as well as their specific characteristics in the ethnopsychoanalytic domain.

This new psychosomatic approach fosters the economic and energic dimension of psychic functioning and its role in somatisations. In formulating the economic principle, Sigmund Freud referred to Carnot's theory in order to justify his viewpoint scientifically. Now, as Carnot's theory applies only to closed mechanical systems, it is no longer appropriate today; this book proposes replacing Carnot's theory with the 'open dissipative energy systems' theory (Ilya Prigogine) adopted in medicine and adapted here to the economic principle of psychoanalysis.

This book is for doctors and psychotherapists concerned with understanding somatisation processes in their patients and helping them in their therapeutic approach; it is also addressed to students of medicine and psychology wishing to supplement their knowledge and practical skills, as well as to general readers with a curiosity about what are still generally referred to as psychosomatic diseases.

As Plato so well observed: 'This is the great error of our day in the treatment of the human body, that physicians separate the soul from the body', Chronicle 156c.


Can the mind really generate a physical disease? Conversely, can the body cause mental illness? What do we know today about their interaction? The relations between body and mind are the source of many problems that are currently treated separately by psychoanalysts and doctors because of the compartmentalisation between their disciplines. Despite differences in clinical practice, we all stand to benefit from a common understanding of the reciprocal influences of the mind and the body and the ways in which these are interrelated. It is time to stop treating the body in isolation from treatment of the mind and to understand that where the psychic apparatus fails in its key task of managing the excitations generated by the tensions and frustrations of everyday life, it is the body that takes over. With a wealth of clinical examples, the author proposes an innovative theoretical and clinical approach that seeks to break down the barriers between biology and psychoanalysis; he also demonstrates its benefits for the health and recovery of patients and its implications for disease prevention.

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