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  • Title: [Psychogenic pain as a representation of the maternal object].
    Author: Hirsch M.
    Journal: Psychother Psychosom Med Psychol; 1989 Jun; 39(6):202-8. PubMed ID: 2664853.
    Abstract:
    Since Freud, psychoanalysis has approached psychogenic pain from two points of view: conversion, and narcissistic hurt through loss of an object (pain of separation). In an early developmental phase concerning the first differentiation of self, body-self and external objects, representatives of physical and psychical pain as well as representatives of frustrating experiences with external objects (emotional deprivation, overstimulation) are able to take the place of each other reciprocally. This means, as Deutsch (1959) has elaborated, the extension of the concept of conversion to pregenital stages and its connection with object-relation-theories. The author suggests an idea of a two phase conversion, by which the primarily acquired defence of conversion is followed by later traumatization, which introduces subsequent conflicts of later developmental stages, for example oedipal ones. In the case of psychogenic pain, where physical and sexual abuse as well as the inherent guilt dynamics are frequently found, they can be integrated by using this hypothetical model. The relation to the conceptualizations of archaic hysterization (McDougall) and secondary hysterization (Mentzos) respectively symbolization (Engel) is discussed; case studies are illustrating the theoretical conception.
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