PubMed1992
There is a group of anxiety neurotics, characterized by trigger experience (specific experience that triggers the anxiety attack at the initial phase of the illness). These are the patients, whose chief clinical manifestation is anxiety attack and anticipatory anxiety, with the additional feature of the recognizable trigger experience. Because of this additional feature, psychotherapeutic approach is often made in these cases. In this article, we present 7 such cases, in which we attempted psychotherapeutic approach with the special emphasis on the reconstruction of their trigger experience. Then we discuss the characteristics of the trigger experience and the therapeutic utilization of its reconstruction. The basic structure of their trigger experience is as follows. 'The experience of being taken by surprise, and shaken off something, which they believed to be, or tried to believe to be, firm and secure to them'. This 'something' is mainly concerned with their self-image. The self-image of 'the person who is healthy and has nothing to do with death, disease and madness' is common to all cases. But they also get different features, and can be divided into 3 subtypes, according to the difference in their self-images. 1. Compulsive-phobic type (case 1, 2, 3); 'the harmless person without impulsiveness and aggression'. 2. Hysterical type (case 4, 5, 6); 'the good mother, doing their best for their children, suppressing their own desire'. 3. Narcissistic type (case 7); 'the manly, energetic and ambitious person'. Symbolically speaking, in the contrast of 'ordinariness and extraordinariness', 'something familiar and something unfamiliar and uncanny', they exclude 'extraordinariness, something unfamiliar and uncanny', and rely only on 'ordinariness, something familiar'. They are clinging to the world of 'ordinariness', and thrown into confusion and anxiety when they catch a glimpse of the world of 'extraordinariness', which they have tried desperately to exclude from their life until then. Therapeutic efficacy of the reconstruction of the trigger experience is summarized in 3 factors as follows. 1. Explanation of their pathogenesis. It is a grave shock to them that the anxiety attack has occurred 'out of the blue' and 'with no reason'. In addition to the general explanation of the pathogenesis of anxiety neurosis, it is a relief to them that the explanation for each individual is possible. 2. Reinforcement of the transference cure ('faith care'). By putting into words what they did not make explicit until then, their belief in the therapist is intensified, and the function of the therapist of endowing them with the basis of security is reinforced.(ABSTRACT TRUNCATED AT 400 WORDS)