Ulcerative rectocolitis has been known for quite some time as a psychosomatic disease, it is an organic disease occurring in people with a particular personality rendering them susceptible to certain conflicts or stress which would be able to play a causing role in the appearance or exacerbations of the disease. Insofar as the psychological study is concerned, there are two important points to keep in mind: the role of psychological trauma as a stimulating factor and the basic personality. In 90% of the cases observed, psychological factors are found as provoking the hemorrage, as found by Groen and confirmed by the author. The basic personality is generally the obsessional type with a hypersensibility to rejection and hostility, sometimes of a paranoid dimension. The aggressivity is almost always repressed. The doctor-patient relationship indicates an important dependency as well as a passivity on the part of the patient. Furthermore, these patients rarely express their feelings, even if their behavior is indicative of experiencing intense emotion. By further experimentation, it has been established that these patients have a greater neuro-vegetative fragility than controls, thus demonstrating a greater vulnerability to stress. A pathological relationship between mother and child has almost always been proven. Finally, the principal causal psychological factor in this disease seems to be a relational conflict unresolved between specific figures. The role of psychotherapy influences greatly the disease evolution. the author recounts an interesting research of 900 ulcerative colitis patients, undertaken by O'Connor. In order to insure favorable therapeutic results in ulcerative rectocolitis, one must carefully coordinate a psychological and somatic treatment.

Colectomy↗

PubMedDate not supplied

[Therapeutic approach in psychosomatic gastroenterology (author's transl)].

The therapeutic approach in psychosomatic medicine requires the somatician to keep psychological factors in mind and the psychiatrist to recall the somatic complaint. The therapeutic attitude will be different according to the psychofunctional problem or an authentic psychosomatic disease. However, in every case, the total patient must be considered and a good doctor-patient relationship must be established. Thanks to this relationship, the doctor can better understand the emotional and intellectual aspects of his patient and therefore plan his therapeutic purposes. Thus it takes into consideration the following: 1. reducing the anxiety by explaining to the patient the possible correlations between his complaints and emotional factors; 2. adopting a supportive attitude; 3. offering to the patient the possibility to explain verbally certain repressed ideas (ventilation psychotherapy); 4. manipulating, if necessary, the milieu in which the patient lives (treatment centered on the environment); 5. starting a deep rooted psychotherapy in certain cases. The problem of psychosomatic diseases in gastro-enterology, like duodenal ulcer and hemorragic ulcerative colitis, is discussed in more details. Concerning duodenal ulcer, one can distinguish between two levels of psychotherapy: 1. psychological approach for the gastro-enterologist with a proper background in the psychological approach of patients; 2. psychotherapy. Anyway, the treatment of this disease is always multidimensional, utilizing both psychological and drug treatment. Concerning hemorragic ulcerative colitis, supportive psychotherapy is crucial during the acute phase. It takes effect by an entire affective relationship with the patient and the all therapeutic team. During a remission, the therapist must provide the patient with the type of relationship he desires, and be available to the patient. In some cases, a deep psychotherapy should be used, even in conjunction with somatic care.

Anxiety↗

PubMedDate not supplied

[Psychosomatic dermatology].

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Aggression↗

PubMedDate not supplied

[Presidential address: reductionism and manicheism].

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Philosophy↗