The Role of Aggression in Somatic Symptom Formation

Abstract

In searching for an operational definition of aggression, five different aspects of the concept of aggression are described: aggression as an instinct, as a behavior pattern, as an emotion, as a trait of character and as a defense. Discussion of the role of aggression is made very difficult because there still exist a great many unsolved fundamental problems in quantifying each aspect of the concept. Behaviorists and psychophysiologists have made important contributions toward solving the problem of quantification. The meaning of aggression for psychosomatic disorders has been intensively studied by psychoanalysts. The psychoanalytic model poses two hypotheses which are subject to critical consideration, namely: 1) the therapeutic meaning of the abreaction of repressed and suppressed strangulated affects [1] and 2) the pensée opératoire [2]. Psychotherapeutic practice is often disappointing in providing answers, but we can look for clarification by studying the specific meaning of patient-doctor relationships in which aggression as an emotion in interaction plays a leading role. In many cases the onset of the somatic symptom may be iatrogenic; the course and recovery may also be dependent on this or analogous relationships.