A Place to Begin
Reina Attias and Jean Goodwin
The aim of this chapter is to describe exemplary cases in which the reworking of past trauma allowed a beginning resolution of bodily symptoms and body-image problems. These four detailed cases bring together theoretical ways of conceptualizing about the body with examples of clinical interventions. We try as well to link each case with paradigmatic scenes and stories drawn from legends, fairy tales or published historical cases, so that readers can associate vivid eidetic images with four types of body problems: the body in many pieces, the death of the core self, the alien and disruptive body and the body whose interior spaces have been poisoned and ruined. It is likely that many other typologies await discovery and description.
In each of these cases a moment arrives in the therapeutic process in which bodily and psychic experience reconnect in a new way that enhances the collaborative endeavor and makes it more meaningful and effective. Therapeutic developments during and after these recognitions illuminate the prior debilitating impacts of body-image distortion. The observed clinical processes of restoration of body-self functioning and body image seem to echo symbols and themes of bodily transformation found in folklore and art.
The first section describes experiences of bodily disintegration and a body image "in many pieces." Recollection of traumatic memories allowed these patients to re-collect the scattered pieces of the body image. The second problem, death of the core self, is illustrated by a patient who experienced episodic self-cutting and an obsessive belief that someone had been killed in