Pain as a Conversion Symptom or a Psychosomatic Phenomenon: Fake or Real?

Abstract

According to the psychoanalytical Freudian approach, the pain in a conversion symptom (hysterical pain), whether defined or indefinable, corresponds to a displacement of the intrapsychic conflict to the subject's physical body. The libidinal energy attached to the repressed representation is transformed into neurotic energy in organs or parts of the body so as to dramatically represent the desirable as well as the prohibitive. The body lends itself as a 'location' to the conversion disorder in order for the anguish of the intrapsychic conflict to be expressed in openly manipulative terms. Does this hysterical pain designate both the pleasure of the performance and the discontent of the psychological anguish? On the contrary, the psychosomatic pain manifests itself in the actual physical body of the organism and not in the illusory body of the hysteric. It is possible for the (psycho)somatic disorder to be expressed through the pain symptom upon an ex- isting, objective condition diagnosed in an organ or body part. But is it not the very nature of the psychosomatic disorder a unique differentiation criterion between the two types of the disorder? The rationale, the type of the psychological defense mechanisms and the nature of the impulsive dynamics which subdue each of those two types of painful symptoms consti- tute criteria of other differentiators within the psychopathological and psychoanalytic approach.