Psychoanalytic Theory of Somatic Disorder Conversion, Specificity, and the Disease Onset Situation

1983

Liaison psychiatry is an outgrowth of consultation psychiatry which it extends by emphasizing its teaching function with the physicians, nurses, and patients it has contact. Liaison teaches methods of identification, assessment, diagnosis, and therapy based primarily on an open-ended interview technique. This form serves in and of itself, as well as by extension, as a brief psychotherapeutic process. The liaison model utilizes a general systems approach in its study of the patient pursuing the latter’s problem from the molecular through organ systems, intrapsychic processes and interactions with the social milieu. The biopsychosocial approach to the patient is one of addressing the patient and the significant others in the sequential stages of illness; acute, convalescent, and rehabilitative. These are largely influenced by the environments and the processes occurring therein. Liaison psychiatry might well be called ecumenical psychiatry inasmuch as it utilizes conceptual approaches derivative of the social sciences, psychoanalysis, behavioral medicine, neuroscience, and psychopharmacology. In addition, the function of the liaison consultant seems to be increasing as one in which he/she functions as an arbiter when there are conflicts between colleagues around decision-making processes. These frequently involve ethical problems affecting the behavior of staff and patients. The processes engaged in by the liaison psychiatrist will be elaborated.

Section: Overviewmentioning

confidence: 99%

Section: The Substance O F Liaisonmentioning

confidence: 99%

The Biopsychosocial Approach. Liaison Medicine and Its Models

1983

“…As time went on, we began to study the situations we were asked to approach and to develop a more descriptive language based on a phenomenological approach. This language included such terms as illness behav ior (10,11), the illness-onset situation, reaction to illness, coping processes (12), adaptation (13), stages of illness, the convalescent stage, the rehabilitative stage (14), the tasks of illness, the intensive care unit syndrome, the terminally-ill patient, the anlaga of illness, grief processes, loss and separation and their re lationship to illness (15), stress and illness (16), illness as stress, the transfer phenomenon (17), illnesses of adaptation (18), behavioral patterns and illness, the coronary-prone patient, behavior pattern type-A (19), the pain-prone patient, grief as dis-ease (20), conservation-withdrawal, the giving-up-given-up syndrome, altered states of consciousness (21), and others. These have become the substance of liaison psychiatry, which essentially in the United States be came the province of those who formerly were the exponents of psychosomatic concepts.…”

Section: Western Medicine's Attempts At Synthesismentioning

confidence: 99%

Liaison Psychiatry as a Systems Approach to Behavior

1979

In this overview, the psychosomatic theory is discussed from an evolutionary perspective. From its initial concern with relationship between emotions and physiology through psychopathology and anatomo-physio-pathology to socio-psycho-pathophysiology, psychosomatic medicine and its theory is presently viewed as an empiric science utilizing a number of conceptual approaches derived from developmental psychology, classical psychiatry, physiology, sociology and anthropology. These are applied to the study and care of patients in ambulatory and inpatient settings, which are the arenas of the consultation-liaison activity and may be viewed as the clinical laboratories of psychosomatic medicine. In these laboratories, a new language has developed which is largely phenomenological and which attempts to utilize theoretical concepts from several disciplines in explaining the illness phenomenon in the present. As such, the practitioner of Liaison Psychiatry is a general systems analyst who analyzes the illness situation of the patient and his attendants in an attempt to decipher the identified problem, explaining it by utilizing selected theoretical concepts from the basic sciences of behavior. Psychosomatic theory is seen as an evolving and bridging science attempting to integrate and combine particulate theory into a more comprehensive synthesis.

“…Kimball noted levels of apathy, dependency, anxiety and adjustment in patients prior to opera tion [20]. Higher mortality was found to occur in given-up [9], apathetic patients. Individuals with strong dependency needs demonstrated greater morbidity, and better adjusted individuals showed both considerably less morbidity and less mortality.…”

mentioning

confidence: 96%

The Experience of Open Heart Surgery

1970

In this report we focus on 11 items used by nurses in rating behavior in the three-week period following cardiac surgery and correlate these with data collected pre-operatively in terms of adaptation, extent of illness, and psychological tests, operative, and post-operative factors. Those patients, who showed greater pre-operative adaptation, were less ill, scored lower on emotional distress, had fewer complications at operation, and a more benign post-operative course, showed less behavioral disturbance. These results serve to emphasize the complex interrelationships between neurological and psychological variables in determining behavior and are reminiscent of much of the work done by Kurt Goldstein with patients who had chronic organic brain syndromes [15].