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NescioSocrates

John 9, 3: Healing of the Blind John 9, 3: Healing of the Blind ManMan

As he went on his way Jesus saw a As he went on his way Jesus saw a man who had been blind from birth. His man who had been blind from birth. His disciples asked him, ‘Rabbi, why was disciples asked him, ‘Rabbi, why was this man born blind? Who sinned, this this man born blind? Who sinned, this man or his parent?’ ‘It is not that he or man or his parent?’ ‘It is not that he or his parents sinned,’ Jesus answered, his parents sinned,’ Jesus answered, ‘he was born blind so that God’s power ‘he was born blind so that God’s power might be displayed in curing him.’might be displayed in curing him.’

Jung, CW 7, para 221Jung, CW 7, para 221

‘‘The process of assimilating the The process of assimilating the unconscious leads to some very unconscious leads to some very remarkable phenomena. It produces in remarkable phenomena. It produces in some patients an unmistakable and some patients an unmistakable and often unpleasant increase of self-often unpleasant increase of self-confidence and deceit: they are full of confidence and deceit: they are full of themselves, they know everything, themselves, they know everything, they imagine themselves to be fully they imagine themselves to be fully informed concerning their informed concerning their unconscious…’unconscious…’

Denise Gimenez Ramos: Denise Gimenez Ramos:

Psyche of the BodyPsyche of the Body

A recent meta-analysis has found that A recent meta-analysis has found that emotional expressiveness is a emotional expressiveness is a predictor of cancer incidence predictor of cancer incidence (McKenna et al., 1999).(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.SourceDepartment 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 DisordersPsychosomatic Disorders

Psychosomatic ReactionsPsychosomatic Reactions Conversion SymptomsConversion Symptoms Functional SyndromesFunctional Syndromes Psychosomatoses (The Holy Seven)Psychosomatoses (The Holy Seven)

Psychosomatic ReactionsPsychosomatic Reactions

Occur in stressful situationsOccur in stressful situations Examples:Examples: giddiness after narrowgiddiness after narrow

escapeescapeloss of appetite after loss of appetite after

bereavementbereavementThrobbing of heart when in Throbbing of heart when in

lovelove Common reactions, which disappear when Common reactions, which disappear when

triggering situation subsidestriggering situation subsides

Conversion SymptomsConversion Symptoms

Secondary somatic response to a neurotic Secondary somatic response to a neurotic conflict. conflict.

Symptoms have a symbolic character and Symptoms have a symbolic character and may be taken to represent an attempt to may be taken to represent an attempt to solve the conflictsolve the conflict

Examples include hysterical paralysis, Examples include hysterical paralysis, paraesthesia, psychogenic blindness, paraesthesia, psychogenic blindness, deafness, paindeafness, pain

Is Chronic Fatigue Syndrome (ME) a Is Chronic Fatigue Syndrome (ME) a modern-day conversion symptom?modern-day conversion symptom?

Functional SyndromesFunctional Syndromes

Various symptoms without identifiable Various symptoms without identifiable organic cause. These can be related to a organic cause. These can be related to a number of organs:number of organs: Heart: palpitations, chest pain, dizzinessHeart: palpitations, chest pain, dizziness Respiratory: hyperventilation, breathing problemsRespiratory: hyperventilation, breathing problems Intestines: Non-ulcer dyspepsia, abdominal pain, Intestines: Non-ulcer dyspepsia, abdominal pain,

diarrhoea (Irritable Bowel Syndrome)diarrhoea (Irritable Bowel Syndrome) Musculo-skeletal: joint pain, back pain Musculo-skeletal: joint pain, back pain

(Fibromyalgia)(Fibromyalgia) Neurology: Headaches, Sleep problems, TicsNeurology: Headaches, Sleep problems, Tics

PsychosomatosesPsychosomatoses

Understood as a primary physical reaction Understood as a primary physical reaction to a conflict situation or stress. There are to a conflict situation or stress. There are objective organic findingsobjective organic findings

‘‘Holy Seven’Holy Seven’ Bronchial AsthmaBronchial Asthma Ulcerative ColitisUlcerative Colitis Essential HypertensionEssential Hypertension Neurodermatitis (Atopic Eczema)Neurodermatitis (Atopic Eczema) Rheumatoid ArthritisRheumatoid Arthritis Duodenal UlcerDuodenal Ulcer AnorexiaAnorexia

Psychosomatic Theories: Psychosomatic Theories: Personality TypologyPersonality Typology

Typology of personality associated with Typology of personality associated with certain types of disease.certain types of disease.

ExamplesExamples Accident Prone Personality: impulsive, Accident Prone Personality: impulsive,

adventurous, poorly controlled, living for the adventurous, poorly controlled, living for the moment, unable to control their aggression moment, unable to control their aggression towards authority. Accident as unconscious self-towards authority. Accident as unconscious self-punishment to assuage guilt feelingspunishment to assuage guilt feelings

Heart Attack Personality: perseverant, success Heart Attack Personality: perseverant, success orientated, self-constraint, controlled, aiming for orientated, self-constraint, controlled, aiming for distant target rather than immediate gratificationdistant target rather than immediate gratification

Psychosomatic Theories:Psychosomatic Theories:

Conversion Model:Conversion Model: Physical Illness as Physical Illness as symbolic expression of an unconscious symbolic expression of an unconscious psychological conflictpsychological conflict

Desomatisation –Resomatisation:Desomatisation –Resomatisation: The process of maturation The process of maturation (Desomatisation) is interrupted by (Desomatisation) is interrupted by neurotic conflicts under stressful neurotic conflicts under stressful situations, leading to regression and situations, leading to regression and physical illness (Resomatisation)physical illness (Resomatisation)

Psychosomatic Theories: Psychosomatic Theories: Disease Specific Disease Specific

Psychodynamic Conflicts Psychodynamic Conflicts (Franz Alexander 1950)(Franz Alexander 1950) Psychosomatic Illness as ‘organ neurosis’ Psychosomatic Illness as ‘organ neurosis’

or ‘vegetative neurosis’: Emotional tension or ‘vegetative neurosis’: Emotional tension cannot be released psychologically and cannot be released psychologically and results in physical organ changes. The results in physical organ changes. The illness is specific to underlying illness is specific to underlying psychological conflictpsychological conflict Hypertension: inhibited aggression in controlled Hypertension: inhibited aggression in controlled

personality cannot be released to the external personality cannot be released to the external world and results in pent-up tensionworld and results in pent-up tension

Duodenal Ulcer: Suppressed (super-ego) and Duodenal Ulcer: Suppressed (super-ego) and frustrated unconscious desire to be pampered, frustrated unconscious desire to be pampered, nurtured and loved mobilises secretion of nurtured and loved mobilises secretion of gastric acid and causes ulcer. gastric acid and causes ulcer.

Psychosomatic Theories: Psychosomatic Theories: AlexithymiaAlexithymia

‘‘Lack of emotion’Lack of emotion’ Based on observation that patient with Based on observation that patient with

psychosomatic illness displayed lack of psychosomatic illness displayed lack of fantasy, poor verbal expression, fixated on fantasy, poor verbal expression, fixated on body manifestations, cut off from body manifestations, cut off from unconscious life, over-adjusted to unconscious life, over-adjusted to environmentenvironment

Ego-regression to a primitive defence system Ego-regression to a primitive defence system with somatisation as expression of with somatisation as expression of aggression and self-destruction; insufficient aggression and self-destruction; insufficient differentiation between self and objectdifferentiation between self and object

Psychosomatic Theories: Psychosomatic Theories: Conditioned learningConditioned learning

Psychosomatic symptoms as consequence Psychosomatic symptoms as consequence of learnt reflexesof learnt reflexes

Physiological predisposition released by Physiological predisposition released by learnt reactionlearnt reaction Asthma: chest tightness with wheezing initially Asthma: chest tightness with wheezing initially

triggered by exposure to allergen. This results triggered by exposure to allergen. This results in increased attention from environment and in in increased attention from environment and in avoidance of disagreeable activity. In future avoidance of disagreeable activity. In future asthma attack set off by wish for attention or asthma attack set off by wish for attention or avoidance of unloved taskavoidance of unloved task

Psychosomatic Theories: Psychosomatic Theories: StressStress

Stress (physical, emotional, social) Stress (physical, emotional, social) results in challenge to the organism. If results in challenge to the organism. If the individual succeeds in overcoming the individual succeeds in overcoming it, a sense of satisfaction is it, a sense of satisfaction is experienced. However, if defeat results experienced. However, if defeat results in feeling of failure, exhaustion and in feeling of failure, exhaustion and various physiological changes various physiological changes (breathing, blood pressure, pulse, (breathing, blood pressure, pulse, cortisol release)cortisol release)

Psychosomatic Theories: Psychosomatic Theories: Integrative ModelsIntegrative Models

Multifactorial origin of illness: interaction of Multifactorial origin of illness: interaction of genetic, microbiological, immunological, nutritional, genetic, microbiological, immunological, nutritional, psychological, social and behavioural factorspsychological, social and behavioural factors

Bio-psycho-social Model: ‘Translation’ of Bio-psycho-social Model: ‘Translation’ of manifestations physical and psychological signals; manifestations physical and psychological signals; attention to psychosomatic and somatopsychic attention to psychosomatic and somatopsychic aspects; attention to biographical factors; aspects; attention to biographical factors; understanding of illness in the context life history; understanding of illness in the context life history; social implications of illnesssocial implications of illness

Viktor v. WeizsViktor v. Weizsäcker: Psyche and body can äcker: Psyche and body can interpret one another; ‘the soul enlightens us about interpret one another; ‘the soul enlightens us about the unconscious reason and passion of the body, the unconscious reason and passion of the body, the body teaches us about the natural needs of the the body teaches us about the natural needs of the soul’soul’