[Psychosomatic pain in the field of gynecology. Stages of the formation of psychosomatic reactions and symptoms with examples of cases (author's transl)].

Der psychosomatische Schmerz in der Gynäkologie. Stufen psychosomatischer Reaktions- und Symptombildung mit Fallbeispielen

Publisher: Georg Thieme Verlag Country of Publication: Germany NLM ID: 0370732 Publication Model: Print Cited Medium: Print ISSN: 0016-5751 (Print) Linking ISSN: 00165751 NLM ISO Abbreviation: Geburtshilfe Frauenheilkd Subsets: MEDLINE

Original Publication: Stuttgart : Georg Thieme Verlag

Pain*; Genital Diseases, Female/*diagnosis ; Psychophysiologic Disorders/*diagnosis; Coitus ; Coitus Interruptus ; Female ; Humans ; Neurotic Disorders

1. Understanding disease in the context of a hermeneutic of the ill person's life history forces us to abandon the old understanding of causality which is represented by the model of body-soul polarity. The real onset of an illness has a biographic pre-history. Long latent periods may occur before and between "functio laesa" and actual damage to the involved organ. On the basis of psychosomatic case histories, we can conclude that the future-orientation of an individual's life, that for which man must make decisions, is also that which causes the crises situation for those who are suffering. 2. Psychosomatic medicine cannot simply be included in an already existing medical discipline such as, for example, perinatology can be included in gynecology or pediatrics. It implies a whole new understanding of illness and, above all, it requires a new attitude on the part of the physician. The patient must be allowed to cooperate in his self-realization; the physician himself becomes the medicine. 3. An attempt was made to illustrate the concept of "organ language" on the basis of 6 brief examples from psychosomatic gynecology. Here only the most important information was presented. According to the concept of "organ language", the soma and psyche of the suffering person can represent and interpret each other reciprocally. It also becomes obvious that conflicts at various strata of being can use one and the same physical symptom if a common denominator is present (e.g., defence overagainst a danger, a disease or a role). This type of teleological nosology implies a new dimension for the consideration a disease, namely, the question of the meaning of suffering. 4. The examples cited are almost exclusively found in the understanding of sexuality in the broadest sense of the word. The threat of individuation as the final personality organization resulting from inadequate realization of the individual's own sex determination (Friedrichs) is present. 5. The sixth example clearly illustrates that sexuality is not what it is commonly considered to be. Rather, it permeates all state of personality and extends beyond them into areas of cultural and intellectual life. Whether or not a woman engages in sexual activity is not important (as had originally been thought). What is important is her attitude toward her own sex, toware her sexual activity and, therefore, also toward her partner and the environment. True sexual activity means infinitely more than just the automatic physiological act. In total self-abandonment to the "Thou", perfect sexual love becomes a knowing penetration of being. Genesis 4:1 states: "Now Adam knew Eve his wife...". The Hebrew word for "know" (yada') means both to know and to beget. Through the mystery of this word, something of the perfection, of the "participation mystique" in the work of creation becomes transparent in the perfect sexual union of two human beings!

Date Created: 19761201 Date Completed: 19770321 Latest Revision: 20061115

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