Symptom substitution after symptom removal.

Abstract

To The Editor.— Increasing interest behavior therapy and the increasingly frequent use of hypnosis recent years has suggested that the old dogma that symptom removal inevitably leads to symptom substitution is not true. Yates, 1 and Ullman and Krasner 2 have dismissed symptom substitution as a psychoanalytic myth. In denouncing the danger of symptom removal by hypnosis, Spiegel 3 reported four cases treated without symptom substitution in addition to thousands of recorded and unrecorded cases of helpful symptom removal accomplished without danger. The following case offers a striking example that symptom removal may on occasion result symptom substitution. Report of a Case.— A 57-year-old woman with complaints of severe abdominal pain had discoid lupus erythematosus for 30 years. Following an iliac bypass, six months prior to her transfer from another hospital, postoperative jaundice led to prolonged recuperation. Liver function eventually returned to normal. At the time of