Psychosomatic Phenomenon
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ELI5
Psychosomatic phenomena aren't just "the mind affecting the body" in a vague way — for Lacan, they only count as truly psychosomatic when desire (not just a biological reflex) is involved, and they belong to a zone of reality that sits outside ordinary neurotic symptoms or relationships with other people.
Definition
The psychosomatic phenomenon, in Lacan's framework, names a specific class of somatic events that cannot be reduced either to pure biological need or to neurotic (imaginary/symbolic) construction. Lacan insists on a precise theoretical criterion: psychosomatic phenomena are only legitimately invoked where desire — the metonymic chain linking need to the field of the Other — is operative. Without the intervention of desire, apparent somatic effects (such as those produced in Pavlovian conditioning) remain at the level of need and reflex, and thus outside the properly psycho-somatic domain. Crucially, however, even when desire is operative, the aphanisis (fading) of the subject may prevent us from fully accounting for that function, marking the psychosomatic as a zone where the subject is at the limit of its own vanishing.
From the vantage point of the early Seminars, Lacan further locates psychosomatic phenomena in the register of the Real — distinguishing them sharply from neurotic constructs (which belong to the Symbolic-Imaginary articulation of ego and other) and from object-relational frameworks. What lies behind the narcissistic structure is autoerotism, the properly intra-organic libidinal investment whose internal economy is, like entropy, fundamentally beyond our ken. The "eroticisation of this or that organ" is the metaphor Lacan finds most adequate to the order of phenomena at stake — not a relation to an external object, but an investment that folds back entirely within the organism. Psychosomatic relations thus occupy a distinct theoretical place: neither symbolic neurosis nor imaginary object-relation, but something at the level of the Real.
Evolution
In the early Seminar II (return-to-freud period), Lacan stakes out the theoretical territory of the psychosomatic primarily through a contrast with narcissism and the object relation. Drawing on Freud's libido theory and its relationship to autoerotism, he argues that psychosomatic phenomena engage the Real — the register of intra-organic investment that is as opaque to us as thermodynamic entropy is to the physicist who can only measure inputs and outputs. The key move here is to distinguish the psychosomatic from neurosis, which operates through the ego-other structure, and from object-relations theory more broadly. The metaphor of organ eroticisation is offered as the closest conceptual handle available.
By Seminar XI (object-a period), the argument is recast in terms of desire, the signifier, and the subject. Lacan uses the Pavlovian experiment as a foil: even there the signifier and the Other (the experimenter) are present, but no genuine subjective effect — no neurosis, no desire — is produced on the animal's side, because there is no subject of the signifier. The criterion for the psychosomatic is therefore sharpened: it requires that need be drawn into the function of desire, and that something of the aphanisis of the subject remain at stake, even if that aphanisis function can no longer be fully accounted for.
The trajectory thus shows a deepening of the conceptual distinction. In Seminar II the key opposition is Real vs. Imaginary/narcissistic; in Seminar XI the key opposition is desire vs. need/reflex, and the question of the subject (its fading) becomes central. The two formulations are complementary rather than contradictory — the Real is precisely where desire meets the somatic in a way that escapes symbolic elaboration — but the later formulation is more tightly articulated within Lacan's developed theory of the subject and the Other. No secondary commentators appear in the supplied passages; both formulations come directly from Lacan's own seminars.
Key formulations
Seminar XI · The Four Fundamental Concepts of Psychoanalysis (alt. translation) (p.243)
If we speak of the psycho-somatic, it is in so far as desire must intervene in it.
This is Lacan's most compressed theoretical criterion for the psychosomatic: desire, not need or reflex, is the condition of possibility for the term to be legitimately deployed.
Seminar XI · The Four Fundamental Concepts of Psychoanalysis (alt. translation) (p.243)
It is in so far as a need will come to be concerned in the function of desire that the psycho-somatic may be conceived as something other than the mere chatter that consists in saying that there is a psychical lining to whatever happens in the somatic field.
Lacan explicitly dismisses naive psycho-somatic discourse ('mere chatter') and anchors a rigorous definition in the structural relation between need and desire.
Seminar II · The Ego in Freud's Theory and in the Technique of Psychoanalysis (p.107)
psychosomatic reactions as such suggest something, it is that they are outside the register of neurotic constructs... Psychosomatic relations are at the level of the real.
This formulation is load-bearing: it places the psychosomatic in the Real, separating it categorically from neurosis and from object-relations theory.
Seminar II · The Ego in Freud's Theory and in the Technique of Psychoanalysis (p.107)
The properly intra-organic investments, which in analysis we call autoerotic, certainly play a very important role in psychosomatic phenomena. The eroticisation of this or that organ is the metaphor which comes up most often, through our sense of what order of phenomena is at stake in psychosomatic phenomena.
Lacan links the psychosomatic to autoerotic libidinal investment — intra-organic, not object-directed — and acknowledges that 'eroticisation of an organ' is the best metaphor available for this opaque register.
Cited examples
the corpus does not deploy concrete examples for this concept
Tensions
Within the corpus
What is the primary theoretical register of the psychosomatic — the Real (as distinct from the Imaginary/narcissistic), or the field of desire and the fading subject (as distinct from need/reflex)?
Lacan (Seminar II): psychosomatic phenomena belong to the Real, contrasted with the narcissistic-imaginary register of neurosis and object relations; the key distinction is between intra-organic autoerotic investment and ego-other structure. — cite: jacques-lacan-seminar-2, p. 107
Lacan (Seminar XI): the psychosomatic is defined by the intervention of desire in need; the subject's aphanisis is the relevant frame, and Pavlovian conditioning is used to show that the mere presence of the signifier and the Other is insufficient without a subject of desire. — cite: jacques-lacan-seminar-11-1, p. 243
This is not a contradiction but a conceptual shift: the earlier formulation stresses Real vs. Imaginary, while the later stresses desire vs. need — reflecting the progressive integration of the subject and the Other into Lacan's account of the psychosomatic.
Across frameworks
vs Ego Psychology
Lacanian: For Lacan, the psychosomatic is explicitly not a function of the ego-other narcissistic structure. Psychosomatic phenomena belong to the Real — the zone of intra-organic investment that lies beyond the ego's imaginary mappings — and their condition of possibility is desire, not ego conflict. Ego psychology's deployment of concepts like 'psychic lining' to somatic events is precisely what Lacan dismisses as 'mere chatter.'
Ego Psychology: Ego psychology (e.g., Franz Alexander's psychosomatic medicine) locates psychosomatic illness in unresolved ego conflicts and suppressed affects that find somatic expression. The ego's defenses are central: conversion, somatisation, and affect dysregulation are mediated by ego mechanisms. The body becomes a site of symbolic expression of intra-psychic tension between ego, id, and superego.
Fault line: Lacan rejects the ego as the mediating agency of the psychosomatic, placing it instead in the Real and conditioning it on desire; ego psychology treats the ego's defensive economy as precisely what needs to be addressed to understand somatic symptoms.
vs Object Oriented Ontology
Lacanian: Lacan's psychosomatic is embedded in a theory of the subject, desire, and the Other: it is a phenomenon that requires the subject's relation to the signifier and to the function of desire, even when the subject fades. The Real here is not a flat ontological register of withdrawn objects but the opaque intra-organic zone that resists symbolic articulation precisely because the subject is structured by lack.
Object Oriented Ontology: Object-Oriented Ontology (Harman, Bryant) would resist the privileging of the subject-desire axis altogether. For OOO, somatic phenomena are interactions among objects — organic, chemical, environmental — that withdraw from any relational or subjective access. The 'psycho' in psychosomatic would be flattened into just another object interacting with others, with no special status for the subject or desire.
Fault line: Lacan's psychosomatic requires a subject structured by desire and lack; OOO dissolves the subject-object asymmetry and would treat the organism's interior as simply another object, making desire irrelevant as a theoretical criterion.
vs Cbt
Lacanian: Lacan insists that psychosomatic phenomena are not reducible to cognitive representations or learned stimulus-response patterns. His critique of Pavlovian conditioning is precisely that it involves the signifier and produces differential perception in the animal, but generates no genuine subjective effect — no desire, no neurosis — because there is no subject of the signifier. Meaning and desire cannot be accounted for by conditioning models.
Cbt: Cognitive-behavioral frameworks (e.g., biopsychosocial models, health psychology) understand psychosomatic phenomena in terms of conditioned responses, cognitive appraisals, stress reactivity, and learned associations between psychological states and physiological responses. Interventions target maladaptive cognitions and behaviors that maintain somatic symptoms.
Fault line: Lacan's argument is that the conditioning/cognitive model can demonstrate differential perception but cannot account for desire or the subject — the very factors that make something genuinely psychosomatic rather than a mere reflex arc extended by associative learning.
All occurrences
Where it appears in the corpus (21)
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#01
Against Understanding, Volume 1: Commentary and Critique in a Lacanian Key · Bruce Fink · p.39
**Beyond Understanding**
Theoretical move: Fink demonstrates that the analyst's avoidance of imaginary projection—through open-ended rather than leading questions—allows the analysand's symptom to speak in its own signifying logic; the clinical vignette shows how tracking the analysand's own words (rather than imposing diagnostic categories) can unlock the unconscious chain underlying a somatic symptom.
the analysand was aware there might well be a certain psychological component to it … The sound that had been bothering him for years seemed to have changed owing to our discussion of it
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#02
Against Understanding, Volume 1: Commentary and Critique in a Lacanian Key · Bruce Fink · p.167
BOTH/AND LOGIC IN A CASE OF FETISHISM
Theoretical move: The passage uses a clinical case to demonstrate how a fetish object (fabric/hem) functions as a plug for the lack in the (m)Other, where the symptom of imaginary stabbing and its fetishistic alleviation are shown to be structurally organized around the subject's encounter with sexual difference and the mother's desire.
W was aware that it was completely psychosomatic—indeed, he initially described it as such—and originated when the doctor gave him the news of his slight heart murmur
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#03
Against Understanding, Volume 1: Commentary and Critique in a Lacanian Key · Bruce Fink · p.215
<span id="page-213-0"></span>MARILYN MONROE AND [MODERN-DAY HYSTERIA](#page-8-0)
Theoretical move: The passage uses Marilyn Monroe as a clinical case study to demonstrate how hysteria manifests as compulsive fabrication that eventually supplants the hysteric's own access to truth, while also foregrounding the methodological problem of unreliable testimony in reconstructing a neurotic's history.
Norma Jeane Mortenson, better known as Marilyn Monroe, suffered from a whole variety of psychological and psychosomatic problems for many years, among them severe depression, chronic insomnia, drug addiction, and alcoholism.
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#04
Against Understanding, Volume 2: Cases and Commentary in a Lacanian Key · Bruce Fink · p.190
<span id="page-36-0"></span>[WHAT'S SO DIFFERENT ABOUT](#page-7-0) LACAN'S APPROACH TO PSYCHOANALYSIS? > **Relations with His Father**
Theoretical move: Through the detailed clinical unfolding of Wesley's case, Fink demonstrates how an obsessional neurotic structure pre-exists and shapes the impact of a traumatic event, and how repressed aggression toward the father—displaced onto the mother, the self, and eventually the transference—is progressively worked through in analysis, with somatic, oneiric, and parapraxic material serving as privileged evidence.
Wesley's own leg would tingle at times when he was thinking about such things, and it turned out to be the same leg his father had cut with the carpet knife (this passing psychosomatic symptom perhaps involved an image of his father as a castrating figure)
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#05
Against Understanding, Volume 2: Cases and Commentary in a Lacanian Key · Bruce Fink · p.18
AGAINST UNDERSTANDING, VOLUME 2 > **Do We Need to Know Why Talking Works as Long as It Does?**
Theoretical move: Fink argues that, given the current cultural-clinical conjuncture dominated by neurobiological reductionism and detachment-oriented meditation practices, psychoanalysts and psychotherapists would do better to defend the brute fact that talking works rather than expending energy on internecine theoretical disputes about why it works.
to whom all psychological problems and psychosomatic pains are merely symptoms of 'chemical imbalances' in the brain
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#06
Bodies to Wear: Four Lacanian Takes on Trans · Patricia Gherovici · p.17
BODIES TO WEAR FOUR LACANIAN TAKES ON TRANS > BODIES ON THE COUCH
Theoretical move: The passage uses the clinical encounter with hysterical and somatic symptoms in a Philadelphia barrio clinic as a launching point to triangulate Butler's theory of gender performativity with Lacan's assertion that "Woman does not exist," arguing that both converge on anti-essentialist grounds while diverging on the question of corporeal reality—a tension made acute by transgender clinical experience.
I heard about somatic symptoms—those physical expressions of anxiety that evade tidy explanation: the sweating, the racing heart, the inexplicable digestive woes, the shallow breaths, the stress-induced migraines.
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#07
Irrepressible Truth: On Lacan's 'The Freudian Thing' · Adrian Johnston · p.42
**2** > <span id="page-38-0"></span>**The Adversary**
Theoretical move: Johnston argues that Lacan's "return to Freud" hinges on a specific, analytic conception of truth as unconscious—identified with the *parlêtre* and the split subject ($)—which serves simultaneously as a critique of ego psychology's false ego/id duality and as the ground for distinguishing Lacanian analysis from all other humanistic or moralistic accounts of repressed verities.
Lacan mentions 'the power of truth… in our very flesh,' he clearly has in mind not only the conversion symptoms of hysteria, but also Freud's chattering fingers, traitorous pores.
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#08
Irrepressible Truth: On Lacan's 'The Freudian Thing' · Adrian Johnston · p.69
**3** > <span id="page-63-0"></span>Soon after, I add:
Theoretical move: Johnston argues that Lacan's relationship to Hegel is one of productive ambivalence rather than outright rejection: Hegel's "cunning of reason" (List der Vernunft) is read by Lacan as proto-psychoanalytic, such that Hegel's own philosophical system undergoes a dialectical self-subversion—the truth of the Freudian unconscious speaks through Hegel's speech about truth, even as Hegel remains deaf to its implications. The unconscious (as speaking Ding) is unavoidable, surfaces in dreams/slips/jokes, and exists exclusively on the surface of symbolic inscription rather than hidden in psychical depths.
these accounts are crucial to their explanations of, among other phenomena, conversion symptoms, psychosomatic afflictions, particular fetishes, and even certain types of psychotic delusions and hallucinations
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#09
Écrits: The First Complete Edition in English · Jacques Lacan · p.244
Presentation on Psychical Causality > **/ .** *Empty Speech and Full Speech in the Psychoanalytic Realisation of the Subject*
Theoretical move: Language—as a symbolic order grounded in the distinction between signifier and signified—is constitutive of the human subject: the word creates the world of things, the Name-of-the-Father grounds the symbolic function of law, and desire itself requires recognition through speech and the symbolic; ignoring this order condemns both Freud's discovery and analytic experience.
The significance of such experiments for psycho-somatic and linguistic research hardly needs further elaboration.
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#10
Seminar XI · The Four Fundamental Concepts of Psychoanalysis (alt. translation) · Jacques Lacan · p.243
THE SUBJECT AND THE OTHER: APHANISIS > THE FIELD OF THE OTHER
Theoretical move: Lacan delimits the scope of Pavlovian conditioning by arguing that conditioned reflexes involve the signifier and the Other (the experimenter), but produce no genuine subjective effect in the animal, since neurosis requires speech and there is no subject of the signifier on the animal's side — thereby clarifying the precise conditions under which desire (not mere need) must be invoked to make sense of psycho-somatic phenomena.
If we speak of the psycho-somatic, it is in so far as desire must intervene in it.
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#11
Seminar II · The Ego in Freud's Theory and in the Technique of Psychoanalysis · Jacques Lacan · p.107
THE FR EUDIAN SCHEMATA OF TH E P S YCHIC APP ARATUS > Introduction to the Entwurf > (Dr Perrier arrives.)
Theoretical move: Lacan argues that psychosomatic phenomena belong to the register of the Real—not the object relation or narcissism—by distinguishing the narcissistic structure (which frames neurosis through ego-other reciprocity) from the properly autoerotic/intra-organic investments that lie beyond conceptual elaboration, and proposes the Real as the precise term for what psychosomatic relations engage.
psychosomatic reactions as such suggest something, it is that they are outside the register of neurotic constructs... Psychosomatic relations are at the level of the real.
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#12
Powers of Horror: An Essay on Abjection · Julia Kristeva · p.61
POWERS OF HORROR > WHY DOES LANGUAGE APPEAR TO BE "ALIEN"?
Theoretical move: Kristeva argues that the collapse of the paternal/condensation function in borderline patients dissolves the sign's constitutive unity of word-presentation and thing-presentation, producing a desperate erotization of abjection as the only remaining anchor to the Other—a position that demands psychoanalysis attend to the heterogeneity of signifiance rather than reducing language to a purely philosophical or Saussurian model.
guarantee its hold on the heterogeneous economy (body and discourse) of the speaking being (and particularly on the psychosomatic 'disturbances' of speech)
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#13
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.41
1. > General Presentation of *The Passions of the Soul* > Passions of the Soul Are Related to the Soul Alone
Theoretical move: By reading Descartes's account of the passions of the soul, the passage argues that the pineal gland figures a paradoxical "soul's body" — a material locus of psychosomatic union that is simultaneously incarnated and abstract, raising the question of whether the brain is the soul's alter ego in self-relation or a genuine alterity that breaches the subject's self-determination.
This feeling of psychosomatic unity is made possible thanks to the intermediary of the pineal gland, which is the material locus of the union.
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#14
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.55
3. > *Brain Events Are Not Enough*
Theoretical move: By invoking Damasio's critique of neuroscientific Cartesianism, the passage argues that reducing subjectivity to brain events alone reproduces a disembodying dualism; a non-reductive neurobiology must treat the brain as an open, fragile structure embedded in organism and environment, which is the condition of possibility for theorising the psychosomatic dimension of affects.
the bodily effects of psychological conflicts that are, in other terms, the psychosomatic dimension of brain events.
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#15
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.87
5. > On Neural Plasticit y, Trauma , and the Loss of Affects > Freud and the Event
Theoretical move: The passage challenges Freud's exclusively positive concept of psychic plasticity—the imperishability and regressibility of all prior mental states—by confronting it with neurobiological evidence that brain lesions can produce irreversible destructions of psychic formations (dreaming, affect, identity), yielding a "purely destructive event" that cannot be integrated, remembered, or made into a moment of personal history.
The formation of a 'new' identity after a brain lesion shows that the primitive psyche is not imperishable, as Freud states; it can be damaged without any return to a previous state.
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#16
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.98
5. > Conclusion > Damasio establishes a distinction between pain and emotion caused by pain:
Theoretical move: The passage argues that neurobiology's discovery of a fully destructible, brain-based unconscious demands a new materialism that radicalizes the concepts of heteroaffection, the death drive, and the nonhuman — moving Continental philosophy beyond its metaphysical residues by confronting the brain as the site of psychic lesions, neural death drives, and a transparent self-model that is process rather than being.
The transparency of the self-model and the anonymity of the emotional brain are the disenchanted wonders of the new psychosomatic and libidinal space.
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#17
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.113
8. > Toward a New Conception of Affects
Theoretical move: The passage argues that affects are reflexive, second-order phenomena — "feelings of feelings" — structured by unconscious mediations that make them irreducibly compound rather than immediately self-evident, thereby extending a Freudian-Lacanian-Hegelian critique of immediacy into affective life and proposing that subjects can systematically misknow their own emotional states (misfelt feelings).
what the hysterical subject misfeels in such telling forms as phobias and psychosomatic conversion symptoms
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#18
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.130
10. > F r e u d 's M e ta p s y c h o l o g i e s of Affective Life
Theoretical move: By tracing Freud's metapsychological treatment of the affect/idea (Affekt/Vorstellung) distinction from 1894 to 1915, the passage argues that Freud's own texts — against their standard reading — open the door to the theoretical possibility of unconscious affects and 'misfelt feelings,' a concept Johnston proposes to resolve the metapsychological ambiguity between affect as necessarily conscious and affect as subject to defensive displacement.
this passage ventures the tentative hypothesis that physiological mechanisms may be responsible for (or, at least, involved in) the elaborate regulatory regime governing the psyche's far-from-straightforward, hardly self-evident affective life.
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#19
Self and Emotional Life: Philosophy, Psychoanalysis, and Neuroscience · Adrian Johnston & Catherine Malabou · p.242
13. > The Paradoxes of the Principle of Constancy > Psychoanalysis: Are There Unconscious Feelings?
Theoretical move: The passage argues that Freud and Lacan's shared thesis—that affects are always conscious and the unconscious is constituted by signifiers/representations, not affects—runs into paradox through the concept of "misfelt feelings" (guilt, anxiety), and that this psychoanalytic topology of drive, representation, and affect is now challenged by neurobiology's discovery of an emotionally competent, symbolically active brain.
Emotion... designates a relational dynamic between brain and body, the very movement of the psychosomatic totality, comprises an individual body and a nervous system.
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#20
Transgender Psychoanalysis: A Lacanian Perspective on Sexual Difference · Patricia Gherovici · p.68
**A NATURAL EXPERIMENT**
Theoretical move: The passage traces the historical construction of transsexualism as a clinical category from Cauldwell through Benjamin and Stoller, showing how the tension between biological and psychoanalytic etiologies structured the field's foundational concepts—particularly the somatic/psychic distinction, the sex/gender split, and the systematic exclusion of psychoanalytic treatment—while embedding pathologizing assumptions that later become the object of Lacanian critique.
It spelled out the distinction Benjamin was establishing between the transvestite (psycho-somatic) and transsexual (somato-psychic) phenomena.
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#21
Transgender Psychoanalysis: A Lacanian Perspective on Sexual Difference · Patricia Gherovici · p.169
**MAKING LIFE LIVABLE** > **The joy of music**
Theoretical move: Through the clinical case of Jay, Gherovici argues that when somatic symptoms exceed the reach of speech and metaphor (remaining in the Real of the body), the sinthome — here enacted through an invocatory-drive transformation into music — provides a singular, artisanal solution that reorganises jouissance and reconstructs the subject's relation to the Other, the Name-of-the-Father, and bodily existence.
the constantly evolving pains haunting his body, did not appear reachable by word association; they did not seem to operate as carriers of a repressed meaning.