Relationship of psychosis and psychosomatic disease.
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In Günther Ammon's structural personality model, psychosomatic illnesses are understood to be the expression of a structural ego-defect--especially in the central ego-function of the body-ego, of identity and of constructive aggression--which owes its origin to an insufficient mother-child symbiosis. The dynamic psychiatric clinic realises an interpersonal field, into which the defects are externalised and remedied by the process of a late ego development. The clinic offers various therapeutical levels: the clinic as a whole, the analytical milieu, group and individual therapy, whereby working-through of the interdependence of patient and staff dynamics has a main integrating function.
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From a 15-year experience with group psychotherapy in psychosomatic patients a plan of such a treatment is presented. In several points it deviates from the model of an intended dynamic group psychotherapy after Höck. These deviations are based on the peculiarities which differentiate psychosomatic patients and neurotics. In particular these are bodily symptoms of the disease, which show lower abilities for the recognition and verbalisation of emotional courses, and the experiences to be freed as a patient from certain struggles. With the help of several graphs is tried to represent the connection of three phases of treatment and their corresponding points.
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The study of the dynamics of aggresion in psychosomatic symptoms has been presented. The study was based on the analytically oriented psychotherapy of 10 psychosomatic patients with different psychosomatic symptoms. The total number of therapeutical sessions was 2,500. In this study a special attention was paid to the key components of psychotherapy of patients suffering from arterial hypertension. Experience of early deprivations are connected with characteristics of the primary object with eventual later inclusion of objects who by their libido could have influence on formation of the basic structure of a personality of these patients as well as reasons of psychosomatic regression. The conclusions may be considered as attempts of integration of some aspects of narcissism theory and self psychology with the author's own concept of the meaning of a "helping" object in development of therapeutical process.
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Not very carefully taking into account a possible psychosomatic pathology in children can, in many occasions, cause the pediatrician to make seriously wrong diagnostic, prognostic and therapeutic evaluations. As this is valid at any age, the authors affirm that particularly at the evolutive age, and since the first months of life, many circumstances occur in which the functional trouble can sometimes a serious organic pathology.
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