This paper reports on the clinical picture of the psychophysiologic disorder of psychogenic vomiting. This term is applied when it is the result of an emotional upset or of a more profound psychic disturbance, and only after no organic pathology was found. Especial emphasis is placed on the careful evaluation of various characteristics of the presenting symptom, i.e., accompanying manifestations, duration, time of day in which it occurs, stressing events related to the vomiting episode, patients’ motivation for psychiatric treatment, their ability to introspect, to verbalize their problems and emotions and their expectations from treatment. Since every variety of personality and every psychiatric disorder may show functional vomiting as a manifestation, the vomiting must be appraised in the context of a complete diagnostic work-up. Treatment will be different according to the various factors considered. For patients who principally present this psychophysiologic disorder, special psychotherapeutic tactics are suggested. The adherence to the tenet ‘treat the symptom, and the person as a whole will benefit’ is useful. The symptom is viewed as the fundamental step to develop the doctor-patient relationship. Special work is done in enabling the patient to become aware of his feelings, and to acknowledge the relationship between the emotions and the physical dysfunction. Clinical examples are described.
This paper outlines general concepts for the utilization of short-term integrative psychotherapy for borderline personalities. It attempts to understand the rationale underlying the application of this therapeutic technique. In arriving at this understanding, consideration should be given to: (1) the technical aspects specific to the briefer procedures such as: time, acceptability, expectations, therapist’s activitiy, focused approach, therapist as a real person, emphasis on patient’s determination, withdrawal and regression, and (2) the particular symptomatic and characterological manifestations of this patient population such as: autonomy, relationships, structure and controls, choice, engulfment drives, fantasied universe, reality and ego functions.
This paper presents concepts of short-term therapy as utilized with borderline personality disorder. Criteria for patient selection as well as contraindications for its use are presented. Many clinical symptoms are rubricated under borderline disorders. One major consideration in diagnosis is based on the discernment of when developmental arrests have occurred. The author’s opinion is that short-term integrative psychotherapeutic procedures can be beneficial for patients struggling with any of the developmental subphases. The concepts expressed in this paper are mostly applicable to more developed individuals, who have progressed in differentiating themselves from others, but who still present primitive characteristics and relationships.
The borderline has deficiencies in the capacity to maintain stable self and object representations and in establishing ‘emotional separateness’ from others. In order to create and maintain a ‘propitious treatment situation’ and a ‘therapeutic alliance’ the therapist must work with unusual sensitivity and repetitiveness on the ground rules of the therapeutic environment. Explicit clarifications of the therapist’s usual constructive attitudes, as a caring, responsive, neutral and real person must be continuously emphasized. The intense psychotic transference potential that leads to therapeutic complications and disruptions can be worked through, if recognized early, through countertransference clues, acceptance of positive aspects of the countertransference and technical moves that enhance the patient’s capacity for individuation and separation, all this within the framework of a structured and consistent therapeutic situation. These assertions are illustrated by specific instances from treatment processes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.