The finger temperature was continuously recorded during psychoanalytic interviews (free association, dream analysis, utilization of the patient's attitude toward the physician, and offering of interpretation of the patient's reactions by the physician; interviews of 50 minutes five times weekly). The patients were asked to describe the emotional reactions they experienced during the interview, and when they did not do this spontaneously, the analyst asked them what their feelings were at given moments. The data thus obtained on emotional reactions (e.g., anxiety, anger, elation) established an indispensable link between psychological and physiological observations. The factors determining the subject's emotional responses and the correlated vegetative events as exemplified by changes in finger temperature were: the subject's personality, his changing life situations, his prolonged mood as expressed by his dreams, the patterning of his aggressive and sexual drives, his activated memories and particularly his reactions to the therapist. The emotional reactions were always complex with one or another affect predominating at the moment. “Complexity” implies several interrelated, qualitatively different emotional reactions occurring simultaneously, or in quick succession. Complexity resulted from the fact that the patient reacted to situations in terms of diverse aspects of personality, e.g., desire for care as well as for independence. It further resulted from the fact that he was reacting simultaneously a) to the analyst, b) to his day-to-day experiences and c) to his early memory patterns. The fall in finger temperature was greatest and most sustained if the patient felt frustrated simultaneously by mate, analyst and parents. The sustained mood of the patient and the intensity and duration of his emotional reactions were dependent on conscious and unconscious dominant attitudes: on the degree of his self-confidence or on the strength of his devices for maintaining a feeling of security in spite of undercurrent stress. Both of these were usually expressed in the dream the patient had during the night preceding the interview. Emotional stress with predominant anxiety, anger, embarrassment, humiliation, joy with anxiety, depression with hostility, guilt, and fear of abandonment, and conflict over the use of hands for aggressive and sexual purposes, were accompanied by a fall in finger temperature. If the patient was not aware of an emotional reaction, but by speech and other behavior did give evidence of experiencing such an emotional reaction (anger, anxiety), there was a fall in finger temperature. At times but not invariably, the fall was of greater magnitude when he was not aware of evident emotional disturbance. During sexual excitement, there was a rise in finger temperature above the control level. The rapidity and degree of fall in finger temperature were determined by the intensity of the patient's emotional conflict and anxiety, whether conscious or unconscious, and by the nature and intensity of his compensatory measures. In individuals who with unconscious motivations developed a life plan of warding off anxiety by avoiding danger, and by the illusion of being master of the situation—anticipation of helplessness, of abandonment, and of injury, although manifest in their defensive behavior, was compatible with high finger temperature, even in potentially threatening situations. However, they reacted with conflict, anxiety and fall in finger temperature when a turn in events disturbed their safety devices. When the patient, in a situation which represented one of stress for him, was in a state of emotional detachment, repressing conflicting impulses and emotions and in addition, maintaining illusory attitudes of security, comfort, superiority, the finger temperature was high and relatively even, as though in a period of genuine security and relaxation. Thus, the finger temperature remained at a high level during states of emotional “objectification” with undercurrent resentment and humiliation, during a state of “forgiveness” for hostility, and during a state of facetiousness with undercurrent murderous and suicidal impulses. If, however, an intensely pleasant emotion, e.g., elation, predominated as a compensatory reaction for repressed anxiety, the finger temperature fell. Repression of conflicting impulses, together with the attainment of security, through illusions of being cared for and of being master of the situation, prevented thus, not only suffering, but also the occurrence of vegetative reactions, except in situations of severe stress. This observation brings into sharp focus the fact that the patient, in the course of psychotherapy, may cling tenaciously to a form of adaptation which was already found inadequate. He does so because his devices save him from anticipated helplessness and suffering, and furthermore, afford him a measure of success in coping with problems and in the attainment of positive satisfaction. He relinquishes this form of adaptation when he becomes capable of functioning without the limiting protection and the illusory support of his devices.
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Sep 4, 2021
Yoshihito Shima + 8
Open Access
