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(2008). Journal of American Academy of Psychoanalysis, 36:143-163

Concreteness, Dreams, and Metaphor: Their Import in a Somatizing Patient

Eileen A. Kohutis, Ph.D.

One of the most challenging types of patients that psychoanalysts encounter in clinical practice are those who are concrete and who also suffer from somatic or somatoform disorders. These patients come for treatment, appear motivated to change, yet they do not change in expectable ways. This paper presents the case of a woman who was concrete and had numerous somatic symptoms. Although she had little interest in talking about her feelings, she expressed herself and her ailments through dreams and it was through her use of dreams that she changed. Dreams were a type of metaphor where the concrete and the symbolic functioned to promote growth.

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