[Male impotence].
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Biomedical subjects
Publications and source records attributed to D Luminet.
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The 'behavioral pattern A' and the 'B' pattern in selected groups of male populations in the framework of a prospective and predictive study of a large population of civil service employees is compared. The Personality Inventory of Lazare, Klerman and Armor and the auto-questionnaire of Bortner were used to differentiate the 'A' and 'B' group populations. Selected cards from Murray's TAT seem more appropriate in this respect and demonstrate the lack of efficiency of certain questionnaires in areas of psychosomatic research. Moreover the selected TAT card responses provide some evidences of 'pensée opératoire' or alexithymia in 'A' group subjects whatever its metapsychological implication.
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The author states that aside from two major digestive psychosomatic conditions, peptic ulcer and ulcero-hemorragic colitis, one only encounters in the adult a widespread psychosomatic pathology, that is to say: 1 degree phenomena of hysterical conversion (gravidic vomiting for example); 2 degrees digestive phenomena concomitant with emotional reactions (diarrhea and anxiety, hypersecretion and anger, constipation and depression etc.); 3 degrees digestive manifestations accompanying anxiety neurosis; 4 degrees authentic functional diseases, such as the irritable colon corresponding to a well defined personality structure. The author concludes this article by some considerations of psychosomatic symptoms observed by the psychoanalyst; he specifically relates the role of the body barrier, the implication of reality and finally the very particular fantasies found in these psychosomatic patients.
We consider the word "impediment" in the meaning of what compels someone, makes someone feel uncomfortable. What are the consequences/implications of seropositivity for the woman in her sexual life, in her motherhood and how does she then cope with it? The following clinical observations account for the suffering induced by seropositivity and the diversity of the processes spontaneously set by HIV-infected women in their sexual life. To answer that suffering, the commonly used psychotherapeutical approach is a palliative one.
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Following the recall of certain basic notions such as anaclitic depression, "abandonic syndrome" and "essential depression", the authors concentrate their interest on the clinical case of an adolescent girl both asthmatic and "abandonic"; the deprivation syndrome is discussed as a consequence of abandonment when the substitutive figure is deficient; the relationship between psychosomatic disorder and perturbations of the mother-child relationship is examined. A certain correlation between anaclitic depression in the infant and "essential depression" in adult life is suggested in the light of a re-enactment of the initial psychosomatic unit.
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The concept of alexithymia introduced by Sifneos is analyzed in relationship to its symptomatology. Its nosographic significance in the framework of character disorders is discussed. The distinction between psychosomatic manifestations and alexithymic behavior must be maintained as their causal relationship put to further questioning. Fiable methods of measurement of alexithymia must be developed so as to give the concept more operational value in the prognosis and treatment of psychosomatic disorders.
Due to his relationship to alcohol which has cut off all other relationship, the alcoholic patient is left alone with a double image of himself: the image of what he has become and the one of what he has been or could have been. The therapist is therefore ill - at - ease in front of this splitting, with varied reactions influenced by his own personality, by the patient's personality and by what alcohol means to both of them. Several attitudes may result from this relational difficulty: rejection and possible referral to a "specialist", symptomatic treatment or rigid, ethical, defensive attitudes. The approach to be alcoholic should pass through acceptance of his relationship to alcohol and the privileged place it occupies in his life so as to enable him to have access to another relationship with some one who restitutes him his human dignity.