Psychoanalytic Psychology, Vol 41(3), Jul 2024, 109-117; doi:10.1037/pap0000487
Psychosomatic symptoms are common and result in high health care costs. An etiological understanding is of importance for psychotherapy. In the present study, a psychosomatic model (the “axis of psychosomatic totality”) developed from clinical experience and previous literature was empirically examined. Twenty patients with psychosomatic symptoms were included in the study. To obtain the greatest possible stratification, all diagnosis groups between the ages of 18 and 65 years eligible for treatment in a psychosomatic clinic were included, for example, primarily mood disorders and neurotic, stress-related and somatoform disorders. A semistructured interview was conducted, audio-documented, and transcribed. A codebook was created based on the first codings. Data from the interviews were analyzed using grounded theory methods. The codes showed good interrater reliability. Statements about bodily symptoms could be assigned to the symbolic pole, asymbolic poles I and II, the imaginary zone, and the logic pole of the axis of psychosomatic totality. Most symptoms could be assigned to the imaginary zone, which reflects the unconscious imaginary body image (n = 157). Symbolic symptoms arising against the background of unconscious conflicts were also frequently mentioned (n = 99), while symptoms on the asymbolic poles I and II were reported less frequently (n = 37, n = 18). In particular, the transitions from the imaginary zone to the adjacent poles were fluid. The dimensions of the axis of psychosomatic totality were directly reflected in the bodily symptoms reported in the interviews. A questionnaire suitable for use in larger psychosomatic samples should now be developed based on patients’ statements. (PsycInfo Database Record (c) 2024 APA, all rights reserved)