Psychosomatic disorder

Question 1

Definition

Answer 1

Psychosomatics is a global approach towards the integration and the entirety of relationships of several - somatic, psychological, social and cultural - systems. Consequently, the term “psychosomatic” does not correspond either to physiological or to psychological processes, but is a concept of functioning of such holistic systems which operate in a socio-cultural environment

• Grinkler

Question 2

Alexander - psychosomatic disease

Answer 2

Theoretically, all diseases are psychosomatic, since the emotional factors influence every somatic processes via the neural and hormonal ways

Question 3

American psychiatric society - psychosomatic disease

Answer 3

Psychophysicl disorders are characterized by physical symptoms elicited by emotional factors, that are associated with - generally autonomically innervated - individual organs or organ-systems. The respective organs are those that are influenced by the emotions anyway, but the changes are stronger and last longer.

The individual is not necessarily aware of his/her emotional state.

Question 4

Different approaches (clinicians)

Answer 4

• the way psychological factors lead to disease is not important
• generally focus on the disease
• they are closer to behaviorism
• they are theory-oriented

Question 5

Different approaches (researchers)

Answer 5

• generally focus on the patient
• the process leading to disease is more interesting
• they are closer to psychoanalysis
• they are diagnosis-oriented

Question 6

Psychoanalytic models

Answer 6

Diseases were regarded as complicated function determined by:

a. inherited factors
b. perinatal complications
c. organic infant diseases
d. characteristics of infant care
e. random physical traumas in infant- and childhood
f. occasional emotional traumas
g. later emotional experiences
h. emotional climate and relationships of the family
i. later physical injuries

d, f, g, h are elements of the so called “psychogenesis”.

Question 7

The classic seven

Answer 7

ALEXANDER

• peptic ulcer
• asthma bronchiale
• theumatoid arthritis
• colities ulcerosa
• essential hypertension
• neurodermatitis
• theyretoxicosis

Question 8

Psychoanalytic models (alexander)

Answer 8

suppressed anger -> circulatory systems

conflict between dependency and sexual desire -> breathing functions

Question 9

Psychoanaltic models (Adler)

Answer 9

Organovulnerability: inherited weakness of some organs

Question 10

Basic Fault

Answer 10

Balint

Question 11

A disease model of Alexander

Answer 11

1. a specific conflict makes the patient vulnerable toward certain diseases but only in the presence of certain genetics, biochemical and physiological factors (X-factors)
2. in certain specific life-situations, to which the patient had become vulnerable by the specific key-conflict, the conflict again appears and becomes stronger.
3. The activated conflict is accompanied by strong emotions which can change functioning and structure via autonomic, hormonal and euro-muscular ways.

Question 12

Cortico-visceral (psychophysiological models)

Answer 12

Pavlov, cannon, Selye

• emotions are accompanied by physiological changes
• conflict or overload of these may lead to disease
• a sensitive, weak organ may contribute
• association between the emotional conflict and the autonomic response > learning.
• pathological activation

Question 13

Neurosis-based (psychophysiological model)

Answer 13

Bykov

• full/partial suppression of emotional reactions
• the organism remains in permanent readiness
• frequent occurrence or permanent subsistence leads to organ dysfunction

Question 14

Individual response pattern specificity

Answer 14

Specific relationships formed among some organ systems and dynamic psychological avoidance mechanisms,

or

Among certain emotional states and organ function.

Question 15

Individual response pattern specificity - adaptation

Answer 15

• evolves during the early development
• strong emotional conflict
• emotional regression

Question 16

Engel´s bip-psycho-social model

Answer 16

1. health, non-health and disease are relative and multifactorial states
2. functional disturbances of the organism may be completely or partially hidden
3. diseases and their consequences always have social, psychological, developmental and physiological component and cannot be studied only by pathophysiology or pathology
4. Disease is an adaptation on a different level or a bankruptcy through defective organism
5. The aim of the therapy should be correcting defective adaptation
6. health, according to these, means complete well-being both in individual and environmental respect: it means homeostasis, whereas disease is then a disturbance of homeostasis.

One important conclusion:
- on certain places and in certain contexts, the psychosomatic disorder may be adaptive!