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Psychotherapy with the hysterical personality: an interpersonal approach.

Personality disturbances are increasingly being defined in terms of person-environment transactions. Puzzling individual behavior may take on fresh significance when viewed within a broader system of forces (Andrews 1966, 1974; Carson 1969; Coyne 1976; Watzlawick et al. 1967). Psychotherapy, in particular, can usefully be viewed as a dyadic system in which both parties endeavor to define the relationship. The purpose of the present paper is to explore the interaction patterns associated with the hysterical personality from this perspective; and to identify relationships between these patterns and the therapeutic tactics which have proven most fruitful with hysterical patients. Since the bulk of clinical literature on hysteria is psychoanalytically based, the main emphasis of this paper will be on psychodynamic therapy. The smaller but growing body of material dealing with behavior therapy provides a fruitful basis for comparison and contrast. New case material will also be introduced to illustrate the main therapeutic principles discussed.

Behavior Therapy↗

Who's hysterical?

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Cognition↗

Evidence for a link between certain psychological factors and the risk of breast cancer in a case-control study. Psycho-Oncologic Group (P.O.G.).

The relationship between psychosomatic characteristics and the risk of breast cancer was studied in women aged from 35 to 65 years, presenting with a clinically palpable breast tumor. To permit a double-blind design, the psychosomatic evaluation obtained by a long open-ended interview was completed before any diagnostic procedure. On the basis of this evaluation, the psychosomatician concluded that the patient was at high or low risk of serious disease. Several other psychological parameters were also recorded, and the diagnosis was then established by cytology or histology. Nineteen of the 77 patients finally included in the study had histologically verified breast cancer. The relative risk (RR) of breast cancer associated with psychosomatic factors was estimated by multivariate unconditional logistic regression, taking into account age at interview, family history of breast cancer, parity and age at first delivery. A significant relationship (p = 0.02) was found between psychosomatic prognosis and the relative risk of breast cancer. Both the low and high risk groups identified by the psychosomaticians had a similar mean age (46.1 versus 47.6 years). Fundamental mental structure played a predominant role in the risk of breast cancer, since no case was observed among the 18 patients with well organized neurosis, and all the 19 malignant tumors were observed among patients with poorly organized neurosis or psychosis (RR = 7.8, p = 0.009). In addition, excessive self-esteem (RR = 10.0, p = 0.02), hysterical disposition (RR = 7.5, p = 0.02), and unresolved recent grief (RR = 8.2, p = 0.05), were found to be significantly related to the risk of breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The seductive patient.

Women referred to as hysterical personalities comprise the largest group of seductive patients. We will discuss (1) how to recognize them, (2) how they behave with physicians, (3) the reactions evoked by them, (4) what brings them to physicians, (5) what they are really seeking, and (6) how to cope with them. To supplement information obtained from patients seen in psychiatric practice, information was gathered from 15 practitioners representing surgical as well as medical specialties.

Female↗

A study of superimposition of hysteria upon epilepsy.

The superimposition of hysteria upon epilepsy was seen in 23 patients out of a group of 758 epileptic outpatients (3.03%). Secondary generalized epilepsy showed the highest prevalence (10.14%). Hysterical fits were seen in 15 patients. Seven patients showed hysterical twilight states. As for the other long-persisting features, the disturbances of motility, ataxias and paralyses without any organic basis were seen in seven patients and hysterical pseudodementia was found in one patient. As provocative factors, a variety of psychological problems was seen in 14 patients and hysterical personalities preexisted in eight patients. In a longitudinal study, the hysterical symptoms were transient in nine patients but they persisted for a long time or superimposed upon epilepsy repetitively in 14 patients.

Adolescent↗