The present paper seeks to propose, using a combination of psychoanalytic and linguistic thinking, a distinction between three degrees of symbolicity across the somatoform dissociative continuum: the metaphorical, in which there is a symbolic connection between the somatoform phenomenon and the traumatic content, the metonymic, which constitutes a revival of the traumatic experience without the ability to reflect on it, and the psychotic, in which the somatoform phenomenon is experienced as ego-syntonic, thus neither causes distress nor evokes thinking. Three clinical vignettes demonstrate how the higher the degree of symbolization, the more effective the therapeutic process. Finally, a fourth vignette demonstrates how acoustic association in the therapist's countertransference can constitute an antidote to the patient's acoustic dissociation, allowing the reclaiming of the capacity for linking.
Bibliographical notePublisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health