Scio
ut
Nescio
Socrates
John 9, 3: Healing of the Blind Man
As he went on his way Jesus saw a man
who had been blind from birth. His
disciples asked him, ‘Rabbi, why was this
man born blind? Who sinned, this man or
his parent?’ ‘It is not that he or his parents
sinned,’ Jesus answered, ‘he was born
blind so that God’s power might be
displayed in curing him.’
Jung, CW 7, para 221
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‘The process of assimilating the
unconscious leads to some very
remarkable phenomena. It produces in
some patients an unmistakable and often
unpleasant increase of self-confidence and
deceit: they are full of themselves, they
know everything, they imagine themselves
to be fully informed concerning their
unconscious…’
Denise Gimenez Ramos:
Psyche of the Body
A recent meta-analysis has found that
emotional expressiveness is a predictor of
cancer incidence (McKenna et al., 1999).
Health Psychol. 1999 Sep;18(5):520-31.
Psychosocial factors and the development of breast cancer: a meta-analysis.
McKenna MC, Zevon MA, Corn B, Rounds J.
Source
Department of Educational Psychology, University of Ilinois at Urbana-Champaign, USA.
Abstract
A meta-analysis examined the relationship between psychosocial factors and the
development of breast cancer. Average effect sizes (Hedges's g) were calculated
from 46 studies for 8 major construct categories: anxiety/depression, childhood
family environment, conflict-avoidant personality, denial/repression coping,
anger expression, extraversion-introversion, stressful life events, and
separation/loss. Significant effect sizes were found for denial/repression coping
(g = .38), separation/loss experiences (g = .29), and stressful life events (g =
.25). Although conflict-avoidant personality style was also significant (g = .19),
the effect size was less robust, and a moderate number of future studies with
null results would reduce the significance. Results overall support only a
modest association between specific psychosocial factors and
breast cancer and are contrary to the conventional wisdom that
personality and stress influence the development of breast
cancer.
Psychosomatic Disorders
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Psychosomatic Reactions
Conversion Symptoms
Functional Syndromes
Psychosomatoses (The Holy Seven)
Psychosomatic Reactions
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Occur in stressful situations
Examples:
giddiness after narrow escape
loss of appetite after
bereavement
Throbbing of heart when in
love
Common reactions, which disappear when
triggering situation subsides
Conversion Symptoms
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Secondary somatic response to a neurotic
conflict.
Symptoms have a symbolic character and may
be taken to represent an attempt to solve the
conflict
Examples include hysterical paralysis,
paraesthesia, psychogenic blindness, deafness,
pain
Is Chronic Fatigue Syndrome (ME) a modern-day
conversion symptom?
Functional Syndromes
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Various symptoms without identifiable organic
cause. These can be related to a number of
organs:
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Heart: palpitations, chest pain, dizziness
Respiratory: hyperventilation, breathing problems
Intestines: Non-ulcer dyspepsia, abdominal pain,
diarrhoea (Irritable Bowel Syndrome)
Musculo-skeletal: joint pain, back pain (Fibromyalgia)
Neurology: Headaches, Sleep problems, Tics
Psychosomatoses
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Understood as a primary physical reaction to a
conflict situation or stress. There are objective
organic findings
‘Holy Seven’
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Bronchial Asthma
Ulcerative Colitis
Essential Hypertension
Neurodermatitis (Atopic Eczema)
Rheumatoid Arthritis
Duodenal Ulcer
Anorexia
Psychosomatic Theories:
Personality Typology
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Typology of personality associated with certain
types of disease.
Examples
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Accident Prone Personality: impulsive, adventurous,
poorly controlled, living for the moment, unable to
control their aggression towards authority. Accident
as unconscious self-punishment to assuage guilt
feelings
Heart Attack Personality: perseverant, success
orientated, self-constraint, controlled, aiming for
distant target rather than immediate gratification
Psychosomatic Theories:
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Conversion Model: Physical Illness as
symbolic expression of an unconscious
psychological conflict
Desomatisation –Resomatisation: The
process of maturation (Desomatisation) is
interrupted by neurotic conflicts under
stressful situations, leading to regression
and physical illness (Resomatisation)
Psychosomatic Theories: Disease
Specific Psychodynamic Conflicts
(Franz Alexander 1950)
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Psychosomatic Illness as ‘organ neurosis’ or
‘vegetative neurosis’: Emotional tension cannot
be released psychologically and results in
physical organ changes. The illness is specific to
underlying psychological conflict
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Hypertension: inhibited aggression in controlled
personality cannot be released to the external world
and results in pent-up tension
Duodenal Ulcer: Suppressed (super-ego) and
frustrated unconscious desire to be pampered,
nurtured and loved mobilises secretion of gastric acid
and causes ulcer.
Psychosomatic Theories:
Alexithymia
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‘Lack of emotion’
Based on observation that patient with
psychosomatic illness displayed lack of fantasy,
poor verbal expression, fixated on body
manifestations, cut off from unconscious life,
over-adjusted to environment
Ego-regression to a primitive defence system
with somatisation as expression of aggression
and self-destruction; insufficient differentiation
between self and object
Psychosomatic Theories:
Conditioned learning
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Psychosomatic symptoms as consequence of
learnt reflexes
Physiological predisposition released by learnt
reaction
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Asthma: chest tightness with wheezing initially
triggered by exposure to allergen. This results in
increased attention from environment and in
avoidance of disagreeable activity. In future asthma
attack set off by wish for attention or avoidance of
unloved task
Psychosomatic Theories: Stress
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Stress (physical, emotional, social) results
in challenge to the organism. If the
individual succeeds in overcoming it, a
sense of satisfaction is experienced.
However, if defeat results in feeling of
failure, exhaustion and various
physiological changes (breathing, blood
pressure, pulse, cortisol release)
Psychosomatic Theories:
Integrative Models
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Multifactorial origin of illness: interaction of genetic,
microbiological, immunological, nutritional,
psychological, social and behavioural factors
Bio-psycho-social Model: ‘Translation’ of manifestations
physical and psychological signals; attention to
psychosomatic and somatopsychic aspects; attention to
biographical factors; understanding of illness in the
context life history; social implications of illness
Viktor v. Weizsäcker: Psyche and body can interpret one
another; ‘the soul enlightens us about the unconscious
reason and passion of the body, the body teaches us
about the natural needs of the soul’