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PubMed1986

[Secret self mutilation, a psychosomatic disease].

The present article contains initial results form systematic psychoanalytic work with patients practicing secret self-mutilation (our term for these is "mimicry patients"). The group we examined was treated on an in-patient basis in a hospital for psychosomatic disorders. The article may be considered as a preliminary report. Up until now the international range of experience is rather limited. We have therefore, made use of this occasion also for developing an applicable clinical definition of the different forms of self-mutilation. This definition is based upon psychological criteria rather than, as has hitherto been the custom, upon the techniques and the morphology of the self-inflicted injuries. Clandestine self-mutilation, in our understanding, is a psychosomatic illness. The self-manipulation has the character of a psychosomatic symptom which, although self-inflicted, is beyond the control of the afflicted individual and is accompanied by extremely reduced consciousness. So far, the experience gained in therapy points to a variety of subconscious conflicts at the back of this symptom, most frequently a severe guilt problem which is not only manifest intrapsychically but also within the family milieu of the patient. On the whole therapeutic results correspond to those observed with other grave psychosomatic disorders accompanied by organic lesions, that is to say improvement sets in slowly after a therapy extending over periods of several months to several years. Initially, a long time before any treatment of the subconscious conflict may be attempted, such therapy must employ supportive ego-consolidating methods and establish a therapeutic alliance. Even so we see no reason for resignation with regard to therapeutic success.

Adult↗
PubMed1985

[Compulsion in neurosis, psychosis and psychosomatic disease].

Obsessive-compulsive phenomena are ubiquitous. Therefore onesided nosological categorization, e.g. viewing obsessive compulsive phenomena as variants of psychosis, seems inappropriate. After discussing these problems of definition, the clinical presentation and relative importance of obsessive-compulsive phenomena in neurosis, psychosis and psychosomatic disorders will be investigated. It will be shown, that the respective obsessive-compulsive syndromes share in common an auto-protective "function", i.e. obsessive-compulsive phenomena can be regarded as a counterregulative attempt of the individual to stabilize unstable structures. That the obsessive-compulsive phenomena tend themselves to have a highly pathological quality, is the reverse of this coping behavior.

Adaptation, Psychological↗
PubMed1988

[Characteristics of personality accentuation as a factor in predisposition to psychosomatic diseases].

Using psychological methods of examination, the authors have studied patients with bronchial asthma (n = 90), duodenal ulcer (n = 70), and ischemic heart disease (IHD) (n = 40). The results have shown the predominance of the dysthymic type of accentuation in patients with ulcer, of the pedantic one in patients with bronchial asthma, and of the excitable, obstructive, and dysthymic one in patients with IHD. All groups have been characterized by the presence of the anxiety and cyclothymic type of accentuation. The revealed characteristics are considered as factors of predisposition to some psychosomatic illnesses.

Adult↗
PubMed1988

[The prognosis of the development of autonomic dysfunction in puberty as the source of psychosomatic diseases in adults].

Comparative study of the incidence of various hereditary, constitutional and environmental factors in two groups of schoolchildren aged 8-18 with (506 subjects) and without (604) clinical signs of autonomic dysregulation yielded a set of indices reliably correlating with the autonomic dysfunction. Sequential statistical analysis after Wald assessed the information value and prognostic thresholds of the indices tabulated as the risk factors for autonomic dysfunction in children and adolescents. The results will be used in regular screening check-ups for the early detection of autonomic dysfunction in children, adolescents and for working out the preventive measures against a number of psychosomatic disorders in adults.

Adolescent↗
PubMedDate not supplied

Disability, psychosomatic disease, and psychoneurosis. The problem of differential vulnerability.

A pattern of cognitive and of affective development characterizing three classes of psychiatric patients is presented: (1) disabled persons, usually unskilled laborers showing a 'somatization reaction', are unable to form abstract categories and, as well, to describe the physiological correlates of 'inner' feelings; (2) psychosomatic patients may show highly developed cognitive skills, although they may not; but they uniformly show a similar inability to 'know' and describe inner feelings; (3) 'neurotic' patients, most dramatically in the phobic category, often show both well-developed cognitive skills and a high degree of sensitivity to, and ability to describe, the symptom complex of anxiety in physiologically relevant forms, with maintenance of meaningful relations with supportive (often 'overprotectively' supportive) family members. These three different states can be diagrammed as follows: (1) -, -; (2) +/-, -; (3) +, +. The suggestion appears that these differences have to do with vulnerability, and that there may be in the general population three separable populations at risk for the development of these three categories of psychiatric disorder. The vulnerability so identified seems to be inversely proportional to 'suitability for interpretative psychotherapy'.

Anxiety↗