[The patient with psychogenic and psychosomatic pain. Outline of psychoanalytically oriented nosology].

Starting with the contribution of G. L. Engel (1959) a systematization of the psychodynamic conceptions of pain and pain disorder is given. Four different explanations for the genesis and maintenance of pain states are worked out: (1) The narcissistic mechanism (substitution), (2) the conversion mechanism (symbolization), introduced by S. Freud himself, (3) the psychovegative mechanism (resomatization), and (4) learning principles. These four conceptions are presented. Finally concern is expressed as the conceptual range of three of these explanatory principles is thought to cover a relevant range by far not reached by other pain theories more en vogue.