A Psychodynamic View of Psychosomatic Medicine

Nemiah, John C.

doi:10.1097/00006842-200005000-00001

Cited by 58 publications

(54 citation statements)

References 7 publications

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“…Nemiah’s [5,6,52] understanding of mechanisms of symptom formation was influenced not only by his study of Freud but also by the writings of Pierre Janet, both of whom learned the importance of dissociated traumatic memories in the production of symptoms from Charcot. In his usual scholarly way, Nemiah drew attention to significant differences between their theoretical formulations.…”

Section: Dissociation Conversion and Somatizationmentioning

confidence: 99%

“…Nemiah [3,4,5,6] was particularly interested in the impact of emotionally traumatic events on mental and bodily processes and in conceptualizing the psychological defenses and deficits that contribute to the development of psychological and somatic symptoms. He gave special importance to the ego defense mechanism of dissociation and also to deficits in emotional awareness and the imaginal capacity, for which Sifneos [7] coined the term alexithymia .…”

Section: Introductionmentioning

confidence: 99%

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Affects, Trauma, and Mechanisms of Symptom Formation: A Tribute to John C. Nemiah, MD (1918–2009)

Taylor¹

2010

Psychother Psychosom

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John Nemiah was interested in the impact of emotionally traumatic events on mental and bodily processes and in conceptualizing the psychological defenses and deficits that contribute to the development of psychological and somatic symptoms. He viewed dissociation as the central psychological mechanism in the formation of a spectrum of symptoms, and conceptualized alexithymia as a deficit in the cognitive processing of emotion such that stress-induced arousal could bypass the psyche and produce somatic symptoms. This article briefly reviews some of Nemiah’s conceptual ideas and relates them to several new theories and concepts and findings from empirical research. His concept of the ‘psychic elaboration’ of emotion is consistent with contemporary theories of the cognitive processing of emotions that emphasize the importance of imagery and linguistic symbolizations. Alexithymia is inversely related to mentalization and is associated with insecure attachment styles and emotional trauma, which influence the capacity to regulate affects induced by stressful events. A multiple code theory of emotional information processing links psychological and somatic symptoms to various degrees of dissociation within and between the elements comprising emotion schemas and to compensatory attempts at repair. Recent studies support Nemiah’s view that alexithymia and intrapsychic conflicts may both contribute to the pathogenesis of panic attacks. There is also substantial evidence of an association between childhood trauma and the development of somatic disease in adult life. Secure attachments and well-developed capacities for symbolization and affect regulation seem to render individuals more resilient to the traumas and stressful events of everyday life.

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Section: Dissociation Conversion and Somatizationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Affects, Trauma, and Mechanisms of Symptom Formation: A Tribute to John C. Nemiah, MD (1918–2009)

Taylor¹

2010

Psychother Psychosom

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“…No fim do século 19 Pierre Janet (citado por Nemiah, 2000), através do caso de Marie, levantou a hipótese psicodinâmica para um processo psicossomático. Janet acreditava que a dissociação era o resultado de uma deficiência na energia psicológica "la misère psychologique".…”

Section: Goetheunclassified

“…Hinkle e Mirsky (citados por Nemiah, 2000) adicionaram uma dimensão ecológica e social aos fatores que podem promover doença.…”

Section: Goetheunclassified

Conceito mente e corpo através da História

Castro¹,

Andrade²,

Müller³

2006

Psicol. estud.

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RESUMO.Este artigo enfoca a evolução dos conceitos de saúde/doença, bem como a dicotomia mente/corpo através de uma breve revisão histórica. Aborda desde o conceito mágico de doença, passando pelo período grego clássico, pela visão medieval e renascentista e a evolução destes construtos com raízes na psicanálise até a psiconeuroimunologia.Palavras-chave: medicina psicossomática, mente e corpo, história da psicossomática. MIND AND BODY CONCEPT THROUGH HISTORYABSTRACT. This article focuses the evolution on the concepts of health/illness and mind/body dichotomy. For this a brief historical review was carried out. It approaches the magic point of view of disease, going by the classic Greek period, through the renascence and medieval prospects, and the evolution of these constructs from psychoanalysis to Psychoneuroimunology. Há síntese maior que o ser vivo GoetheTanto o conceito de saúde e doença quanto a discussão da relação mente e corpo têm sido objeto de interesse ao longo da história. A superstição, a magia e o ato de curar eram mesclados e a figura do médico e sacerdote encontrava-se neste amálgama, como atesta o homem (médico) com a máscara de cervo encontrada na caverna de Trois Frères, datada de cerca de 16000 anos, tida como a mais antiga representação do homem curador de enfermidades (Calder, 1970). Segundo Ramos (1994), o xamã era o mediador entre as forças cósmicas e o doente. Outras civilizações antigas, como a assírio-babilônica, davam conta da associação dos demônios e doenças, como era o caso das doenças oculares, atribuídas ao vento Demônio do Sudoeste. Na mitologia grega várias divindades estão vinculadas à saúde:Apolo, Esculápio, Higéia e Panacéia. Já em um período posterior grego, Hipócrates, Platão e Aristóteles já consideravam a unidade indivisível do ser humano.Platão descrevia a alma como preexistente ao corpo e a ele sobrevivente, enquanto Aristóteles postulava que todo o organismo é a síntese de dois princípios: matéria e forma. A visão popular de doença atribuía as enfermidades aos deuses, como pode ser observado no caso da peste que afligiu os gregos, descrita na Ilíada de Homero. Hipócrates de Cós (460 a.C.), que deu à medicina o espírito científico, em uma tentativa de explicar os estados de enfermidade e saúde, postulou a existência de quatro fluidos (humores) principais no corpo: bile amarela, bile negra, fleuma e sangue; desta forma, a saúde era baseada no equilíbrio destes elementos. Ele via o homem como uma unidade organizada e entendia a doença como uma desorganização deste estado (Volich, 2000). Karol (citado por Porto, 1924) acrescenta que a partir destes conceitos Hipócrates afirmava que os asmáticos deviam se resguardar da raiva. Ressalta ainda que, no período helênico, Demócrito via o corpo como uma tenda (skênos), habitação natural da alma, tida como a causa da vida e da sensação. A teoria democritiana preconizava que os átomos da alma (que eram finos e

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“…Jahrhundert und vor allem im 20. Jahrhundert lassen sich mehrere Entwicklungsstränge ausmachen, die von besonderer Relevanz für unser heutiges Verständnis von Psychosomatik sind [Übersicht: 2,3,4,5]. Diese Tendenzen sind unter speziellen soziokulturellen und wissenschaftshistorischen Bedingungen entstanden.…”

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Psychosomatische Medizin – Geschichte, Definition, Extension, Organisation

Kapfhammer

2010

psychiatr. psychother.

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Psychosomatic medicine defines a medical perspective that investigates biological, psychological and social influences on origin, onset and course of somatic diseases and functional bodily syndromes in a systematic and balanced way, and that stresses a patient-centred approach in treatment. There are various historical pathways, manifold scientific and health care interests making definition and range of psychosomatic medicine difficult. Central areas of psychosomatic work are the comorbidity of somatic diseases and psychological disorders, syndromes of somatization, impaired styles of coping with medical conditions and difficult illness behaviour, and the psychological and psychosocial sequelae of chronic diseases. Following a biopsychosocial model psychosomatic treatments favour both psychotherapeutic and psychopharmacological strategies. Within health delivery system there is consensus to promote a general psychosomatic perspective in medical education and qualification and to strengthen psychosomatic competencies in primary care and medical specialties. As a proper medical specialty psychosomatic medicine refers to consultation-liaison services at its main professional area. At an academic level an independent clinical department may be justified in respect of the manifold tasks of education and research. There is a major need of psychosomatic rehabilitation within modern society. Regarding separate psychosomatic inpatient facilities there is a fierce controversy in German-speaking countries between the specialities of psychosomatic medicine and psychotherapy on the one hand and psychiatry and psychotherapy on the other.

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A Psychodynamic View of Psychosomatic Medicine

Abstract: Psychodynamic observations and theory have important implications for psychosomatic research and treatment.

Cited by 58 publications

References 7 publications

Affects, Trauma, and Mechanisms of Symptom Formation: A Tribute to John C. Nemiah, MD (1918–2009)

Affects, Trauma, and Mechanisms of Symptom Formation: A Tribute to John C. Nemiah, MD (1918–2009)

Conceito mente e corpo através da História

Psychosomatische Medizin – Geschichte, Definition, Extension, Organisation

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