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Abstract: After having defined the structure of personality, the author examines its destiny late in life. If certain structures keep up in old age such as well internalised neuroses, others end up in actual neuroses or undergo a massive destructuring process, as in Alzheimer''s disease. Using the psychosomatic theory of the Paris School (Pierre Marty), which emphasizes trauma and fixations, the author inquires into these different clinical configurations as well as into their possible relations. [Copyright &y& Elsevier]

Background: Postpartum depression (PPD) and poor childbirth outcomes are associated with poverty; these variables should be addressed by an adapted approach. The aim of this research was to evaluate the impact of an antenatal programme based on a novel psychosomatic approach to pregnancy and delivery, regarding the risk of PPD and childbirth outcomes in disadvantaged women., Methods: A multi-centre, randomized, controlled trial comparing a novel to standard antenatal programme. Primary outcome was depressive symptoms (using EPDS) and secondary outcome was preterm childbirth (fewer 37 weeks). The sample comprised 184 couples in which the women were identified to be at PPD risk by validated interview. The study was conducted in three public hospitals with comparable standards of perinatal care. Women were randomly distributed in to an experimental group (EG) or a control group (CG), and evaluated twice: during pregnancy (T1) and four weeks post-partum (T2). At T2, the variables were compared using the chi square test. Data analysis was based on intention to treat. The novel programme used the Tourné psychosomatic approach focusing on body awareness sensations, construction of an individualized childbirth model, and attachment. The 10 group antenatal sessions each lasted two hours, with one telephone conversation between sessions. In the control group, the participants choose the standard model of antenatal education, i.e., 8 to 10 two-hour sessions focused on childbirth by obstetrical prophylaxis., Results: A difference of 11.2% was noted in postpartum percentages of PPD risk (EPDS ≥ 12): 34.3% (24) in EG and 45.5% (27) in CG (p = 0.26). The number of depressive symptoms among EG women decreased at T2 (intragroup p = 0.01). Premature childbirth was four times less in EG women: three (4.4%) compared to 13 (22.4%) among CG women (p = 0.003). Birth weight was higher in EG women (p = 0.01)., Conclusions: The decrease of depressive symptoms in women was not conclusive. However, because birth weight was higher and the rate of preterm childbirth was lower in the EG, our results suggest that the psychosomatic approach may be more helpful to the target population than the standard antenatal programs.

On September 1-2, 1983, the Third International Workshop on Respiratory Psychophysiology will be held in Bordeaux, France. The program includes topics such as normal human respiration during wakefulness and sleep, emotional factors, breathing patterns, stress-related changes, biofeedback of respiratory functions and cardiorespiratory correlations. Special attention will be given to psychophysiological approaches to bronchial asthma and other psychosomatic applications such as hyperventilation and dyspnea.

In the past few years there has been a dramatic increase in the number of psychoanalytic publications on the topic of psychosomatic illness, including edited collections and special editions of psychoanalytic journals. This paper is a critical conceptual review of the topic of psychosomatic illness using the material contained in a number of these recent publications as a basis, but also drawing on other works by the key authors of the publications discussed herein. This paper proposes that currently there appear to be two schools of thought around the origin, development, and treatment of psychosomatic symptoms. The first of these is the well-established "Paris School of Psychosomatics." The second approach does not formally exist, but is referred to in this paper as the "Attachment approach" since there are a number of authors who theorize about the treatment of psychosomatic symptoms in a similar and important way. The paper will compare and contrast the two approaches with respect to their underlying theories, treatment approaches, and conceptualization of the mind-body problem, with particular attention paid to how this is related to mentalization. The understanding of how problems in mentalization may be linked to psychosomatic illness can be conceptualized as the "speechless mind" from the perspective of the Paris School and as the "speaking body" by the Attachment approach. The paper concludes by engaging with these two conceptualizations and suggests that in order for an individual to achieve both psychological and physical health, the work of sensation must be located primarily in the logic and function of the body, while the work of making sense of these sensations and interpreting them must be located in the mind.

After a historical survey in which the history of the term "psychosomatic" and its invention during the 19th century are retold, as is also the history of modern psychosomatics, the author offers a more personal view, the result of her experience as a classical psychoanalyst and as a practitioner for 27 years at the Paris Institute of Psychosomatics. She develops her current understanding of the theories of the Paris School of Psychosomatics, and selects and elaborates a certain number of concepts essential for clinical work with patients suffering from somatic illnesses. Detailed case studies of two very different patients who are both ill with cancer offer an attempt to show the relevance and application of this specific approach, but which still remains based on psychoanalysis and the most rigorous Freudian metapsychology.

The technical term of psycho-somatical disease appeared during World War I. Then, Babinski's arguments were surrounded by expert's debates; boundary between neurosis and psychosis remained indefinable for a long while. Finally, and despite the tremendous lot of energy invested in their work by doctors, it must be said that the main part of World War I mental wounded don't recover because diagnoses were uncertain and therapeutics on the blink.

Clinicians trained in dermatology and having submitted themselves to psychoanalysis have developed an original psychosomatic approach to skin disease at the Tarnier Hospital (Cochin-Port Royal University Hospital Center). Its mainspring is detection and management of the patient's distress. The author analyzes the conditions under which it was possible to carry out this experiment and the implications of this approach which is directed at achieving a change in the way the department is run rather than adding one more specialized appendage to the outpatient care activity.