Believing in the patient's capacity to know his mind: A psychoanalytic case study of fibromyalgia


Journal Article

Fibromyalgia is currently viewed as a disorder of pain and stress processing in the central nervous system. Various stressors in combination with constitutional and genetic factors can trigger the syndrome, and the way the brain processes stress has been linked to early relationship experiences. The author discusses the relationship between fibromyalgia and attachment dynamics in the context of a clinical analysis, and draws inferences about the intrapsychic origins of functional brain abnormalities seen in neuroimaging studies. The patient had core deficits in his capacity to mentalize and self-soothe, and catastrophized somatic sensory information. Because his capacity for self-reflective mentalization was so limited, interpretation of underlying conflict-ridden affect at first did little good. The analyst's most productive intervention was a consistent meta-communication of belief in the patient's capacity to know his own mind. Copyright © Melvin Bornstein, Joseph Lichtenberg, Donald Silver.

Full Text

Duke Authors

Cited Authors

  • Griffies, WS

Published Date

  • September 1, 2010

Published In

Volume / Issue

  • 30 / 5

Start / End Page

  • 390 - 404

Electronic International Standard Serial Number (EISSN)

  • 1940-9133

International Standard Serial Number (ISSN)

  • 0735-1690

Digital Object Identifier (DOI)

  • 10.1080/07351690.2010.482389

Citation Source

  • Scopus