KMID : 0385320180290040072
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Journal of Korean Psychoanalytic Society 2018 Volume.29 No. 4 p.72 ~ p.82
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Communication with Psychosomatic Patient: With a Clinical Vignette ¡°When Words Are Unspeakable: A Bridge Beyond the Silence¡±
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Jahng Eun-Jin
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Abstract
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What should a therapist do if the patient has lost the ability to speak in sessions? How should the therapist understand and approach this ¡®deadly silence¡¯? Psychosomatic patients have poor ability to mentalize their experience, so they create a ¡®shunt¡¯ from emotional experience to body bypassing symbolic sphere. This makes psychosomatic patients vulnerable to expressing their emotions in words. With the case vignette ¡®When words are unspeakable: a bridge beyond the silence¡¯ written by Wirth in a book ¡°From soma to symbol¡± we observe how psychosomatic pathology arises, from inappropriate mirroring and poor containment; and how this escalates into a vicious cycle of sin and punishment in the patient¡¯s conscience. This conscience scenario imprisons a talented and creative mind in a dark, silent place, wherein symbols and words are forbidden. This seemingly impossible task of providing silent patients with a ¡®talking cure¡¯ finds breakthrough with containment, and transformative thinking using therapists¡¯ reveries.
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KEYWORD
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Psychosomatic, Containing, Dream thinking, Transformative thinking, Reverie
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