regression in service of the ego: a psychosomatic origin


When we speak about the return of the repressed, we are addressing a condition that is very closely associated with the repetition compulsion.  In other words we are talking about a condition that repeats itself despite the fact that there is no etiological reason for the repetition.  

Take the case of an illness that started in a rather benign fashion.  Let’s use the condition of a kidney stone.  What we know about kidney stones is that they are nearly as painful as child-birth.  Now let us move to a situation where the pain of the kidney stone remains despite the fact that the stone is removed.  Add to this mix a recent traumatic event like the adoption of a foster child too late in life for it to be comfortable for the mother.

Here we have the makings of the return of the repressed.  What is repressed is repressed because it has been relegated to a position in the mind that is not easily assessable.  What make it assessable to ordinary consciousness is a situation that although is not a kidney stone, it has enough of the characteristics of a kidney stone to go searching the unconscious for a past event that created that kind of pain.  The mind is attempting in a psychosomatic condition to explain the presence of a pain that ought not be there.

The return of the repressed is the returning to consciousness, in a disguised manner, some previous pain but now associated with a current event.  We hook material from the vast unconscious by looking for items that exist in that warehouse that can explain a current event.  

In this case we have a recent adoption of a foster child (pain of child birth).  The pain of child birth merges with the pain of the kidney stone until the consciousness mind does not know the difference. While the kidney stone has long been passed, the associated memory of child birth now remains in the unconscious associated with the process of adopting and caring for an older more difficult child.

As the organism begins to understand that it can not tolerate the disruption at age 66 of having a new baby, the organism fights the knowledge, because the fostering papers are signed and the new baby is at home.  it become clear that to care for this child will be impossible.  Every time the patient realizes that she will not have the courage to keep this baby, the return of the repressed comes forward filled with ancient incapacities, overwhelmed with ancient feelings that she could not cope with in the past.

In other words what was a kidney pain, is now a perpetual pain of giving birth…without the baby ever really being born.  Conflict over disappointing spouse and child mount in such a way that indicates that there is not an  easy way out of the situation.  The “birth” canal is blocked, the baby is never born, but the pain of giving birth is incessant.

You would think that the understanding of this psychosomatic condition would bring about some relief, but the knowledge that the repressed exist does not in any way alter the repressed from finding a crack in the pavement through which to attack the mind/body.

The body is being attacked with pain because pain is the body’s instinct to alert the organism that something is very wrong.  If you were to be able to put your hand in the fire and not feel the flames burn, you would disintegrate before your very eyes.  The pain of the burn makes a request of the mind to withdraw the hand from the flame.

But think further for a moment, what if a phantom pain is not being effective in warning the organism that it is burning alive.  The pain would continue and intensify.  Now if you add to this mix that the cause of the pain is not being removed you have a situation where the body is yelling—stop, stop, stop, but no one is listening.

The pain is saying you must make a change now–give birth, pull your hand out of the fire.  Do what it take to stop this insult on the body.  But to stop the insult on the body means to disappoint loved ones, the spouse and the newly adopted child.  So the very thought of making the change that needs to be made in order to eliminate the pain, brings about a conflict that rises the stress level and it is the stress level that then activates the pain.

In short the mechanism of pain to danger has become distorted in a new way…the pain of the original kidney stone is not the cause; but the distraction becomes informed in a new way that a new cause of danger is lurking.  In this case the complete conflict that it causes everyone to have to unmake a decision that everyone had counted on being a permanent decision.

Even though the problem is being addressed and this understanding is beginning to be seen with clarity; nonetheless, the source of the pain is still not eradicated.  The conflict is no longer, “I will have to do this which I can not do for the rest of my life and it may kill me”; the new conflict is, “I will be inflicting pain on people that I love when I have to  tell this child that that he will not be able to live here with us.”

So to recapture, first the kidney stone, then the foster adoption, then the cognition that,”I can not do this.”  This is followed by rummaging through the unc. to look for a similar situation to explain the pain….the child birth canal is blocked and the pain of giving birth continues as long as the child is not born. In this case, as long as the child is still there to remind the unconscious that the only thing that will change the situation is for the resolution to include that the child is delivered back to the center from which he came and a new home needs to be found….(the hand is pulled out of the fire)

From the very beginning the route that the pain took never changed, only different triggers set off the pain.  In its current manifestation as long as the boy has not been told and the situation does not change the “stone” pain will continue.

In the return of the repressed, every thing that ever made up loss and pain and abuse and suffering comes back to the surface to both overwhelm the organism and also to flood it with pain to remind it that unless the condition is not fully addressed the old circuitous route will remain in operation.

Consciousness and insight alone are not sufficient to bring about a cure.  What is needed is a complete belief that I am doing this to myself instead of doing what I need to be doing.  Once the pain route are activated by feelings, overwhelmed, fear, contrition, sorrow, grief, the pain will remain at the mercy of the emotional condition.

In the early 20th century when Hysteria was first confronted, the rate of hysterical conversion was astronomical compared to what it is today.  What cured the planet of hysteria was a common belief that it did not exist as a condition of the body but existed as a creation of the mind.

Such is true for the conversion of psychosomatic pain to a return to homeostasis.