ABSTRACT
This paper deals with familiar findings in the field of schizophrenic psychosis re-interpreted from a medical anthropological (V. Weizsäcker) as well as theoretical pathological (W. Dörr) view-point. Schizophrenic psychosis is thus discussed as an existential illness of the person as well as an aesthetic challenge for a certain cultural framework. This paper therefore investigates phenomenologically three main points that are not new but ought to be continuously re-considered: 1. The cultural-scientific thesis of a uniform onto- and pathogeny: Schizophrenic psychosis serves as topical example for the genetic and ontogenetic uniformity of so-called organic and psychic illnesses. 2. The anthropological thesis of the existential "Spiegelfunktion" of schizophrenic psychosis: From the phenomenological point of view, schizophrenic psychosis is defined as an existential illness hitting and reflecting the primary nature of human beings in a shocking way. 3. The therapeutic thesis of the effect and scientific basis of the paradoxical intervention: This thesis aims at describing the impossibility of understanding schizophrenic psychosis as a pathological but rather an anthropological phenomenon and problem of life, the acknowledgment of which shows therapeutic effect. The article's main concern is to discuss schizophrenic psychosis as phenomenon of existence and suffering, however not understandable, yet reflective of the existential predicament of humanity. This cultural-scientific concern is considered a permanent aim of subject-oriented medical analysis.
Subject(s)
Existentialism , Schizophrenic Psychology , Anthropology , Humans , Schizophrenia/genetics , Schizophrenia/therapyABSTRACT
The term psychosomatic medicine has two meanings: first it represents a specific scientific approach in medicine that encompasses methodologies from natural sciences as well as social and human sciences. Second it denotes a clinical speciality that aims at applying this complex scientific background to diagnostic and therapeutic procedures. In this review partly contrasting concepts in medicine are outlined in order to discuss current psychosomatic theories and models. This reflection based on philosophy of science shows that the heterogeneity of the concepts in medicine expresses differences in the predominance of phenomenologic, dialectic, empiric-analytic and hermeneutic methodology. In psychosomatic medicine a critical evaluation and integration of the applied methodologies is regarded as scientific prerequisite and ethical demand. These hypotheses are also shared by medical anthropology (v. Weizsäcker), theoretical pathology (Doerr and Schipperges), and by the concepts of Uexküll (Situationskreis) and Hahn (Methodenkreis); they also serve as the fundamental basis for this article.
Subject(s)
Mind-Body Relations, Metaphysical , Models, Psychological , Psychological Theory , Psychosomatic Medicine/history , Austria , Forecasting , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , History, Medieval , Humans , Physician-Patient Relations , Psychosomatic Medicine/trends , Sick RoleABSTRACT
The author discusses four basic theoretical methodological approaches elaborated by H. Seiffert and R. Lay which were recommended by R. Vogt and in particular P. Hahn for medicine and psychology. The author explains also primary diagnostic methods used in psychotherapy. Due to the aspect of medical anthropology these basic methods are considered aspects of genetic epidemiology and at the same time as theoretical guidelines for the diagnosis and therapy of anthropological dimensions of diseases. Traditional combination of all diagnostic methods from the "clinical aspect" is then substituted by specific differentiation at the point of intersection of objective and subjective facts concerning the disease.
Subject(s)
Psychotherapy/methods , HumansABSTRACT
The doctor-patient relationship is described as a specific form of interaction also in patients with endogenous psychosis. In this relationship the characteristics of the basic personality structure underlying the disease process are being revealed. The schizophrenic psychotic patient can thus experience a revival of the specific human - the mortal nature transcending - theme of existential philosophy and the aspect of aggression as part of man's social existence. This can lead to a higher level of sophistication and enhance his healing process. Thymoleptic and neuroleptic drugs are viewed as helpful in the establishment of a solid doctor-patient relationship which is a precondition to recognize and possible solve the structural problems underlying the disease process. Insights derived from the rehabilitation of endogenous psychotic patients specially of social psychiatric departments are used as heuristic models also for the every-day praxis.
Subject(s)
Physician-Patient Relations , Psychotic Disorders/therapy , Communication , Depressive Disorder/therapy , Ego , Humans , Psychotic Disorders/psychology , Schizophrenia/therapy , Self ConceptABSTRACT
41 patients with a depressive syndrome in middle age (mean age 55 years) were investigated. 19 of them had purely monopolar depressive syndromes without any organic features; 22 patients had a depressive syndrome associated with an organic brain disease (11 vascular, 11 primary degenerative disease). In all patients psychiatric and neurological investigations, a WAIS test, an EEG and a computer tomography were performed. The clinical findings were significantly different in both groups of depression but there was still a considerable overlap of symptoms. The EEG was inconclusive, the psychological test (WAIS) and the computer tomography showed the clearest separation between the organic and the nonorganic depressions leaving only 10% of inconclusive findings. Therefore, it may be concluded that the differential diagnosis of organic or nonorganic depressive syndrome in middle age cannot be made on the basis of one investigation on its own but on the combined results of clinical, functional, and morphological examinations.
Subject(s)
Depressive Disorder/diagnosis , Neurocognitive Disorders/diagnosis , Cerebrovascular Circulation , Depressive Disorder/psychology , Diagnosis, Differential , Electroencephalography , Female , Humans , Male , Mental Processes , Middle Aged , Neurocognitive Disorders/psychology , Tomography, X-Ray Computed , Wechsler ScalesABSTRACT
By means of psychiatric depth-psychological investigations in more than 100 patients with PCP the somatopsychic aspect of the disease is described, which manifests itself in two thirds of the patients as an inhibited to agitated humble-depressive psychosyndrome. On the basis of family anamneses and analytical inquiries the somatopsychic aspects of the disease is described in more the half of the patients as consistent continuation of a specific way of life, so that psychosomatic and somatopsychic aspects of the disease are mentioned as one strategy persuing the same fictitious goal. Both aspects appear as functions of a seemingly threatened psychic-physical motivity.
Subject(s)
Arthritis, Rheumatoid/psychology , Personality Disorders/etiology , Adjustment Disorders/etiology , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
In 106 patients with rheumatoid arthritis it could be shown by Adlerian Psychology that in more than half of the patients both physical over activity before the disease and painful inhibition of movement during the disease were an imaginary solution of the problem. Both are functions of a threatened mental and physical mobility and autonomy. In pointing out this relationship we aim to show lifestyle as a risk factor for the disease and indicate causative therapeutic aspects.
Subject(s)
Arthritis, Rheumatoid/psychology , Adult , Arthritis, Rheumatoid/complications , Attitude to Health , Chronic Disease , Depression/etiology , Humans , Life Style , Physical ExertionABSTRACT
The effects of hysterectomy on social and psychological behavioural changes were evaluated in 88 patients who were examined psychologically and somatically preoperatively and for a period of 5 to 6 months postoperatively. All patients were aware of the surgical consequences and were investigated in regard to social history and by means of psychological tests (HAWIE, MMPI, Rorschach). The personality profiles of these patients fell within the normal range, although showing a tendency towards psychosomatic alteration, which, however, decreased significantly after the operation. Hysterectomy does not appear to produce any clear-cut changes in the attitude toward sexuality according to the findings of this study. Neither the age at which sexual maturity was reached, nor the intelligence level, number of children, age nor social class appeared to show any significant influence on the capacity to achieve orgasm or the frequency of intercourse. Only three patients showed transient postoperative depression, although this is frequently described in the literature; its aetiology is discussed. The therapeutic approach, especially in the field of surgical gynaecology, must encompass every aspect of medicine and appropriate explanations of the surgical consequences should be given to the patients to prevent postoperative psychological complications.
