5
Views
1
CrossRef citations to date
0
Altmetric
Original Article

The psychological facet of psychosomatic disturbances

&
Pages 47-54 | Published online: 08 Jul 2009
 

Abstract

The first part of this paper deals with the psychological background to the most common difficulties in the relation between doctors and patients, particularly when the two parties disagree about the diagnostic and therapeutic approach to a psychosomatic affection. The following causes for discord are discussed:

Alexithymia—a mental deficiency that obstructs the insight into the connection between emotional and physical reactions to all types of life experiences;

Anal object relationships—a disturbance of the psychosexual development in early childhood, involving in particular the risk of a destructive struggle for power between the patient and the doctor;

Regression—the return to a more infantile stage of behaviour in a person who had once passed that stage, involving the risk of mistrust and hatred from the patient towards a doctor whom he conceives as coldhearted and repudiating;

Gain of illness—unconscious psychic defence mechanisms that are often misunderstood and may lead the unwise and unsuspecting doctor to fateful errors of treatment and management.

The second part describes the tactics for a fruitful cooperation between doctor and patient in regard to the investigation and management of gastrointestinal complaints, possibly originating from psychosomatic reactions to stress and other psychological and social strains.

Before the diagnosis is made, it is essential to pursue in parallel two lines of investigation—the somatic and the psychosocial—to avoid one line impeding advances along the other.

When a thorough somatic examination has made it clear that the patient's complaints are not caused by an organic disease and the patient's search for a psychosomatic connection has not yet been successful, the so-called redirectional work remains. An account of this work and plain rules for its accomplishment are given.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.