{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T18:13:34Z","timestamp":1771870414937,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2005,3,22]],"date-time":"2005-03-22T00:00:00Z","timestamp":1111449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Analytical Psychology"],"published-print":{"date-parts":[[2005,4]]},"abstract":"<jats:p><jats:bold>Abstract:\u2002<\/jats:bold> This paper explores the dynamics brought into analytic work when there is a symmetric fusion between psyche and soma within the patient. It will consider how such a fusion may emerge from reverberations between physical constitution and a lack of maternal attunement, containment and reflective function. I will describe the work with a patient, Jane, who was diagnosed with Myalgic Encephalomyelitis (ME) during the course of her analysis. The dynamic of her physical symptoms within the analytic work, and the impact of her internal affects and internal \u2018objects\u2019 within the transference and countertransference, indicated a difficulty in finding an homeostatic balance resulting in overactivity and underactivity at both somatic and psychological levels.<\/jats:p><jats:p>Using the clinical work with Jane this paper will also examine the interrelationship between mother\u2010infant attachment, an inadequate internalized maternal reflective function, affect dysregulation, unconscious fusion, the lack of psyche\u2010soma differentiation and the impact of the latter in relation to internal regulation systems, or lack of, in patients with Chronic Fatigue Syndrome (CFS) and Myalgic Encephalomyelitis (ME). I will draw on similar work carried out by <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#b13\">Holland (1997)<\/jats:ext-link>, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#b28\">Simpson (1997)<\/jats:ext-link> and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#b29\">Simpson et al. (1997)<\/jats:ext-link>. The paper will also employ the concept of the reflective function (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#b8\">Fonagy 2001<\/jats:ext-link>; <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#b18\">Knox 2003<\/jats:ext-link>), and consider <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#b22\">Matte\u2010Blanco's (1999)<\/jats:ext-link> concepts of generalization and unconscious symmetry in relation to the patient's internal world. I go on to consider how analysis provides a point outside the \u2018fusion\u2019 that can enable the \u2018deadlock\u2019 to be broken.<\/jats:p>","DOI":"10.1111\/j.0021-8774.2005.00520.x","type":"journal-article","created":{"date-parts":[[2005,3,22]],"date-time":"2005-03-22T15:00:26Z","timestamp":1111503626000},"page":"155-173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["An under\u2010active or over\u2010active internal world?"],"prefix":"10.1111","volume":"50","author":[{"given":"Christine","family":"Driver","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,3,22]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-5922.1997.00237.x"},{"key":"e_1_2_15_3_1","volume-title":"Second Thoughts","author":"Bion W. 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