[Correlation between anxiety and pain in the first gynecological examination of children and adolescents].
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Biomedical subjects
Publications and source records attributed to I Rechenberger.
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Pruritus is a psychosomatic phenomenon which may be triggered physically and has psychic consequences. Pruritus may, however, also be triggered psychically and have a physical substrate as a consequence. The present study attempts to contribute to the understanding of the psychic origin of itching. Itching is considered as an affect and an analogy with behaviour patterns from the animal kingdom is pointed out. If the doctor perceives his patient's affects he can by interpretation help the patient to perceive unconscious affects and thus to recognize the cause of the itch. The symptom may then disappear.
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Psychopathology occurs much more frequently in cases of persisting than in juvenile acne. Moreover, a neurotic personality structure is much more common in cases of persisting than juvenile acne. When a neurotic structure is present, the juvenile acne patient maladjusts to the acne and develops neurotic symptoms. Such psychological consequences represent further stress and cause exacerbations, thus transforming the juvenile into persisting acne. The increased psychopathology in persisting acne is thus both a result as well as a partial cause. It is a link in a vicious circle. The typical pathological patterns of reaction in acne are described.
Women with only minor anatomical deviations may request plastic surgery in an attempt to compensate a feeling of inadequacy or humiliation. Psychological evaluation may be warranted to preclude a number of possible sequels: feeling of cold, shivering and shaking, lasting for days, with or without conjunctivitis and rhinitis vasomotorica; hypochondriacal and paranoid tendencies, mistrustfulness and misunderstandings in regard to the doctor. The doctor's assent to the operation and performing of the operation may increase the feeling of humiliation instead of alleviating it.
When organizing a consultative service and a psychosomatic consultation-hour at a dermatological clinic the following (specific?) peculiarities resulted: 1) the fellow doctors at the clinic at first only sent somatically untreatable cases and 2) were afraid of a correction of their diagnosis. 3) By way of identification they were faced with their own proper problems. The patients understood themselves to be physically ill and at first could not be approached regarding to their subconscious conflicts. The actual conduct of the patients in the wards and their attitude to the physicians was used in a psychodiagnostical way (whereas analytical interpretations were dispensed with) and was used therapeutically to elucidate the psycho-genesis of their affliction. Only with some singular patients suffering from skin-diseases a proper analysis could be performed for research purposes; most of them had to be treated simultaneously dermatologically as well as psychoanalytically (in a modified way). Merely with patients suffering from andrological troubles group-therapy along analytical lines was feasible and proved to be successful.
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