Psychosomatic Process Research Articles

Prenatal Mindfulness Training and Interoceptive Awareness in Pregnant People at Risk for Hypertensive Disorders.

Aim: In this secondary analysis of a pilot randomized controlled trial (RCT), we sought to examine whether mindfulness training (MT) is associated with change in interoceptive awareness in pregnant people at risk for hypertension using quantitative and qualitative methods. Interoceptive awareness is the perception, regulation, and integration of bodily sensations. Interoceptive awareness increases following MT and has been proposed as a psychosomatic process underlying hypertension outside of pregnancy. Methods: Twenty-nine participants (mean age 32 ± 4 years; 67% White) with a history of hypertensive disorders of pregnancy (HDP) were enrolled at 16 weeks' gestation (SD = 3) for a RCT assessing the feasibility and acceptability of an 8-week phone-delivered MT intervention. Fifteen participants were randomized to MT, whereas 14 were randomized to usual prenatal care. Before and after the intervention, all participants completed the Multidimensional Assessment of Interoceptive Awareness (MAIA) measure and participated an individual interview, which queried for mind-body changes noticed across the study period. Results: Adjusting for baseline interoceptive awareness and gestational age, participants randomized to MT reported less worry about physical sensations on the MAIA after the intervention compared to those randomized to usual care. Qualitative data corroborated these results; MT participants described improved awareness of body and breath sensations, ability to notice blood pressure changes, non-judgmental observation of thoughts, and improved responses to interpersonal challenges. Conclusions: MT may improve the ability to notice body sensations that arise in pregnancy in a way that promotes healthy responding rather than worry. Results provide support for interoceptive awareness as a potential mechanism through which mindfulness may modulate blood pressure and potentially reduce the prevalence of HDP. Clinical Trial Registration: ClinicalTrials.gov (NCT03679117).

PSYCHOSOMATIC MANIFESTATIONS OF MILITARY PSYCHOTRAUMA

Introduction. War is a super-powerful extreme event that causes adaptive capacity to decline. The need for a clearer understanding of the specifics of war psychotrauma and its clinical consequences for all components of human health determines the relevance of the topic of this study.
 The aim of the work is to study the peculiarities of psychosomatic relationships in persons with the consequences of war psychotrauma.
 Materials and methods. The experimental study group consisted of 32 patients from the number of temporarily displaced persons, the control group – 34 patients who did not change their place of residence during the entire period of the full-scale war. The diagnosis was aimed at identifying neurotic, stress-related and somatoform disorders, according to the rubric (F40-F48) of the ICD-10. Assessment of the somatic condition was carried out on the basis of analysis of anamnestic data, clinical examination of the patient and indicators of laboratory tests. Psychodiagnostic methods were used to assess the mental states of patients (Clinical Questionnaire for the Detection and Assessment of Neurotic States; Methodology for the express diagnosis of neurosis by K. Heck and H. Hess; Questionnaire SAN (Mood, Activity, Mood); Methodology for the diagnosis of Taylor's anxiety level; Self-assessment of mental states according to Eysenck; Ch. Spibleger's Reactive and Personal Anxiety Assessment Scale in the modification of Y. Hanin. Statistical processing of the research results was carried out in the Microsoft Excel program and with the help of the Social Science Statistics online calculator.
 Results. As a result of the analysis of anamnestic data, clinical examination and analysis of laboratory tests, psychosomatic disorders were found in patients of both research groups: in 29 (90.63%) patients of the experimental group and in 26 (74.47%) patients of the control group.
 Conclusions. It has been confirmed that a prolonged stressful extreme situation of a full-scale war causes the formation of negative mental states accompanied by psychosomatic manifestations, the formation of a closed vicious circle of a pathological psychosomatic process. A high close direct correlation was found between the level of reactive anxiety, autonomic disorders, well-being, activity, mood of patients and psychosomatic symptoms. The absence of a statistically significant difference in the risk of developing psychosomatic disorders as a result of war psychotrauma in temporarily displaced persons and those who did not change their place of residence was revealed.

An Aesthetics of Chinese Calligraphy

AbstractThis article introduces the aesthetic significance of Chinese calligraphy, one of the highest art forms in China. It focuses on three major aesthetic concerns manifested in classical texts on this art. First, Chinese art theory stresses that the forms (xing) of successful calligraphic works are never static; rather, they should be filled with internal force (shi). Second, calligraphic creation can be understood as a psychosomatic process, that is, involving coordination between the mind and the hand. Third, appreciation of Chinese calligraphy is identified with the process of reconstructing the calligrapher's creation of the work, which is analogous to Richard Wollheim's identifying criticism as retrieval. The last section examines the concept of qi and discusses what kind of aesthetic considerations encourage us to make a connection between Chinese calligraphy and abstract art.

The Psychosomatic Arc in Therapy

The psychosomatic arc, based on an idea of Nossrat Peseschkian in 1988, was further developed by the author from 1994 on to visualize the process of body and mental symptoms caused by life events and microtraumatic situations of everyday life. A semi-structured psychosomatic treatment process is described by which to understand the function and language of psychosomatic symptoms more easily. Keywords: psychosomatic arc, positive psychosomatic, positive psychotherapy, psychosomatic disorders, visualization in psychosomatic treatment

Accelerating Learners’ Self-confidence Level in Second Language Acquisition: A Qualitative Study

Second Language Acquisition (SLA) is a complex psychosomatic process. As per educational psychology, its acquisition process depends on some affective determinants related to learners' self-confidence that accelerates learners’ zeal of learning the language. However, studies are rare to empirically explore the factors or the ways that help learners build their self-confidence level. Thus, the prime focus of this study is to find out factors associated with accelerating learners’ self-confidence in SLA through a qualitative case study. Data have been collected through semi-structured interviews carried out over the phone due to the COVID-19 pandemic. A total of 13 respondents (7 boys and 6 girls) have been interviewed who have recently completed their postgraduation. The obtained data have been analyzed with the help of the content analysis technique. The study finds that the self-confidence of a learner gets accelerated by three main factors like motivational factor, social factor, and environmental factor which motivate a learner to learn L2. Based on the findings, some policy recommendations have been suggested to further improve L2 learners’ self-confidence level.

Young adults’ transition to a plant-based diet as a psychosomatic process: A psychoanalytically informed perspective

This study examined transition to a plant-based diet by young adults and the challenges and conflicts this brings. Interviews were conducted with nine young adults in Sweden and the answers were analysed guided by a psychological method from descriptive phenomenology. The results indicate that the transition to a plant-based diet is a process comprising five dimensions: 1) Exploring new ways of living based on health anxieties, 2) regulating conflicting emotions through differentiation, 3) transforming traditional models into new alternatives, 4) confirming new skills and abilities and 5) integrating experiences and emotions into a whole. These five dimensions reflect how transition to a plant-based diet is experienced physically and emotionally. The results also indicate that plant-based meals and ingredients used in the new diet are loaded with symbols and conflicting emotions. Psychoanalytically informed theory, especially object relation theory, was used in discussing what can happen to the mind during the transition. In a wider perspective, this study provides insights into how a dietary transition can bring stability to the life of young adults and help them endure and master their situation. More research is needed to assess the role of mental health in transitioning to a plant-based diet and to draw more general conclusions, an area where psychodynamic theory can provide insights.

Crises através dos tempos

O objeto desta análise é compreender o papel da crítica de arte, na visão de Ernesto Sábato, ao elencar sua contribuição ao Simpósio da I Bienal Latino-Americana de 1978. Evidenciamos sua concepção de mundo, ao comparar a vida baseada na idolatria da técnica e na exploração pelo homem. Consideramos as variabilidades ético-morais e a atualidade de seu pensamento, voltada ao questionamento psicossomático do homem, sua eterna busca e transcendência, diante de crises sociopolíticas e morais. Avaliamos seu discurso crítico, os processos míticos evidenciados nas reflexões dialéticas sobre a arte e a identidade dos diversos movimentos filosóficos narrados.

ОСОБЛИВОСТІ ЕКСПРЕСІЇ ОСІБ З РІЗНОЮ СХИЛЬНІСТЮ ДО АЛЕКСИТИМІЇ

Статтю присвячено проблемі розпізнавання власних емоційних переживань та їх зовнішніх виразів. Схильність особистості до розпізнавання емоцій через сприйняття експресії розглядається як усталена, багатокомпонентна, інтегральна властивість, що забезпечує точність, адекватність розуміння своїх емоційних переживань і переживань іншого. Актуальність розробки проблеми пов’язана з дефіцитом соціальних зв’язків, відсутністю досвіду в розпізнаванні емоцій, особливо в ситуації розвитку Інтернет-Комунікацій, що призводить до редукції емоційної лексики сучасної людини. Процес соціальної адаптації неможливий без здатності особистості розуміти та диференціювати емоції. Це спричинює необхідність вивчення здатності особистості до адекватного визначення власних емоційних станів і розуміння власного експресивного репертуару. Дослідження ґрунтується на припущенні, що труднощі розпізнавання власних емоцій та їх експресивних виявів можуть бути пов’язані з різною схильністю особистості до алекситимії. Алекситимія розглядається як нездатність сприймати, відчувати і називати словом (lexis) свої почуття, свої емоції (thymos).Мета роботи полягає у дослідження здатності до розуміння та розпізнавання власних експресивних проявів емоцій в осіб, котрі різняться схильністю до алекситимії. Розкрито поняття алекситимії як чинника розуміння емоцій; вивчено співвідношення між показниками означених змінних; виявлено осіб, схильних і не схильних до алекситимії, та визначено й порівняно особливості їх експресії. Емпірично встановлена наявність значимого від’ємного зв’язку між показниками виразної експресії та алекситимії.Показано, що тенденція до збільшення рівня алекситимії гальмує здатність особистості до експресивних проявів власних емоційних переживань, а прояви успішного розпізнавання власної експресії демонструють особи, котрі не виявили схильності до алекситимії.Доведено, що схильність до алекситимії є одним із психологічних чинників здатності особистості не тільки розуміти власні емоції, а й здатності ідентифікувати і використовувати власний експресивний репертуар, його можливості та ресурси.

The association of temperament with nausea and vomiting during early pregnancy

ABSRACTWe aimed to investigate the relationship between affective temperaments and the severity of nausea and vomiting symptoms in early pregnancy (NVP). The pregnant women who did (n = 187) or did not report (n = 71) any nausea and vomiting at three consecutive assessments with the Pregnancy-Unique Quantification of Emesis Scoring Index (PUQE) (n = 71) were examined. Affective temperamental traits were assessed by Temperament Evaluation of Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A). The anxious (p < .0001), depressive (p = .003), cyclothymic (p = .03) and irritable (p = .021) temperament traits in NVP patients were significantly higher than in controls. There were significant correlations between the PUQE scores and depressive (p = .002), cyclothymic (p = .001), irritable (p = .001) and anxious (p = .001) traits. Anxious temparement (p = .004) and being a housewife (p = .012) were significantly associated with NVP. Our results suggest that women with a predominantly anxious temperament are more vulnerable to developing somatic complaints such as nausea and vomiting during pregnancy.IMPACT STATEMENTWhat is already known on this subject? Although some studies have examined the link between NVP and some psychiatric disorders, to our knowledge the relationship between NVP and affective temperament has not been well investigated.What do the results of this study add? Predominantly anxious temperament make the individuals vulnerable to develop some somatic complaints such as nausea and vomiting during pregnancy.What are the implications of these findings for clinical practice and/or further research? The association of temperament and NVP might be linked to a psychosomatic process in pregnancy. Future research are required to examine the associations of temperament with NVP by including several other biological, social and psychological variables.

Association Between Work-Related Stress and Coronary Heart Disease: A Review of Prospective Studies Through the Job Strain, Effort-Reward Balance, and Organizational Justice Models.

Work‐related stress is an example of a psychosocial risk factor that has become of interest in today's ever‐demanding, fast‐paced, and globalized society, although its link to adverse health and in particular coronary heart disease (CHD) is incompletely understood. In this review, we will

Gih (Qi): Beyond Affordance.

Ancient Eastern thought posited the ontological integration of the “mind-body world”. The body-mind syncretism was a foundational precept in Eastern philosophy in which “Gih” (“Qi”) was considered the basic entity of the universe and the human being. This study attempts to build a meta-theory and to demonstrate empirical designs for Gih, discussing the problems of the mind and body, or the subject and object, compared with the concept of “affordance” proposed by ecological approaches. The notion of Gih extends beyond that of affordance in that Gih activates a psychosomatic process between the physical condition and the mental state that facilitates the bi-directional interactions between subject and object. Therefore, the concept of Gih integrates mind and body, providing a means of comparing Eastern and Western philosophical systems.

Psychosomatic process in patients with dissociative mental disorders

Present days are characterized by increased level of various psychosomatic disorders among different populations in economically developing counties. Moreover every mental disease contains somatic symptoms and these symptoms may interfere in whole picture, change the diagnostic schedule. In case of mild disorders patient's reaction to somatic disease was mostly hysteric: exaggeration of pathological sensations, suggestibility and self-suggestibility. Whole picture of the neurosis was very colourful, dynamical, with instable pathological manifestations, intention to draw one's attention.Transition to long-term variant of dynamics mental disorder was accompanied by concentration on the smallest somatic sensations, seeking benefit from a disease state, “flight into the illness”, nosophilia. We identified prominent increase of hypochondriac symptoms in the group of patients with long course of dissociative disorders (33.4%) as compared with the group of acute and sub-acute course of the disorder (11.4%).In patients with long course of dissociative disorders we observed accumulation of somatic pathology, in most cases one patient suffered from different somatic diseases. Increasing of rate of hypertension (31.33%) and different dishormonal disorders (37.5%) was the most prominent.In psychological “portrait” of the patients with psychosomatic disorders we identified the great number of combinations of pathocharacterologic traits, creating the patient's “facade”, complicating interactions and compliance with physicians and psychiatrists.Interactions between features of mental disorders and somatic disorders, psychological stress appear to us to be rather close. Presence of the somatic process leads to chronification of the neuroses, “flight into the illness”, decrease of dependence of clinical dynamics on psychogenics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

On the Question of a Hypothetical Psychosomatic Process in Depression

Nous examinons d’abord la legitimite d’une conceptualisation de certains aspects de la depression en tant que processus psychosomatique qui touche le cerveau. La medication est parfois necessaire, surtout dans des cas ou le transfert, qui est un puissant antidepresseur, n’arrive pas a etre engage. Mais, au contraire, il existe un autre type de « sortie » de la depression par la cure psychanalytique, dans les cas ou, le transfert est operant, et ce type laisserait au sujet la possibilite de faire le deuil du « manque de l’Autre » par des formations poetiques/metaphoriques de l’inconscient.

Insomnia From Disease or Disaster?

To the Editor: We read with interest the article by Ogdie et al1 on the contextual factors of diagnostic errors, and were impressed with the authors’ novel use of narrative discussion to educate residents about such errors. Our own education about the sometimes-misleading power of context occurred in our hospital in May 2011, when an 82-year-old Japanese woman presented with a 2.5-month history of appetite loss, weight loss, and insomnia. She arrived not long after the Great Eastern Japan Earthquake of March 11, 2011. Although she lived in Tokyo, approximately 500 km away from the stricken areas, she reported that after the earthquake, she had felt anxiety and had gradually decreased her oral intake, watching television news programs about the disaster every day. At that time, we knew that the disaster had not only overwhelmed individuals’ daily lives in Eastern Japan but had also had a great impact on the mental status of those who lived far away from the stricken areas. The combination of the patient’s symptoms raised the possibility of a psychosomatic process due to the negative influence of the earthquakes. Still, we discussed her case with an internal medicine resident and evaluated the patient for organic diseases. Her erythrocyte sedimentation rate was 79 mm/h. The laboratory test results were otherwise almost normal. We considered subacute bacterial endocarditis, polymyalgia rheumatica, and a malignant process as differential diagnoses. Blood cultures were sterile. But esophageal-gastro-duodenoscopy revealed an advanced gastric cancer; pathology showed diffuse large B-cell lymphoma. In reflecting on the role of the earthquake in our patient’s condition, we initially speculated that the two events (i.e., the patient’s disease and the earthquake) occurred coincidentally. But we soon saw that this was misleading. In fact, since the disaster, the number of patients in Japan with mood or psychosomatic conditions as well as somatic symptoms has been increasing, which sometimes distracts the decision making of their physicians. For the 82-year old woman, the unprecedented disaster in March 2011 helped make her neurotic, which masked the prodrome of aggressive lymphoma. Unavoidable contextual factors, no matter how “sorrowful” they are, can often psychologically distort physicians’ cognition. Junwa Kunimatsu, MD Attending physician, Department of Internal Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan; [email protected] Atsuto Yoshizawa, MD Director, Department of Internal Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan.

Le concept heuristique d’affections psychosomatiques du cerveau

Psychosomatic disorders are classically related to the body outside the brain. Yet, there is no reason why the circuits of the brain should not be affected by a psychosomatic process. For Lacan the psychosomatic phenomena are related to the creation of a conditioned reaction of the organism through signifiers, which having frozen and therefore lost their signifying function, are transformed into signals, which coming from the Other, obtain an imperative quality for the organism, thus disturbing its function. The author postulates that these signals could affect through conditioning certain cerebral circuits as well. Peirce's Phaneroscopy helps us conceptualise this procedure as a semiotic reduction which proceeds from the thirdness of the signifier to the secondness of the signal (which can bring about conditioned reflexes or reactions of a different kind) or even go further to the firstness of complete automation of stimuli. Thirdness is the specific semiotic modality for humans and when thirdness is reduced, the body gets ill. Yet, beyond the typical psychosomatic phenomena this process of semiotic reduction could also apply to mood disorders and other clinical conditions likewise. Through the process of semiotic reduction we can distinguish neurological diseases from psychosomatic brain procedures that are part of certain psychiatric disorders. In these psychiatric disorders the cerebral circuits, which are affected, are in relation to the semiotic thirdness. The neurophysiologic mechanisms of kindling and excitotoxicity might be involved in the psychosomatic processes of these neuronal circuits.

Präoperatives, sensomotorisches Training bei Implantation einer Hüft-Totalprothese: eine randomisierte kontrollierte Studie

AIMS: The aim of this study was to investigate whether pre-operative, sensory-motor movement-training as a standard treatment-programme results in improved Physical Function, Quality-of-Life and Sensory-Motor-Function and reduced Disability in patients undergoing Total-Hip-Replacement. METHODS: 80 subjects awaiting Total-Hip-Replacement (mean-age 66.8±10.3; 31 women) at a Swiss regional hospital were consecutively recruited to this Randomised Controlled Trial. The intervention-group undertook a pre-operative 2-6 week home-exercise sensory-motor training-programme, the control-group received no therapy. Following surgery both groups underwent a standard physiotherapy-programme. The Primary Outcome-Measure was Physical Function, secondary Outcome-Measures were Quality-of-Life, Disability and Sensory-Motor-Function. Outcomes were measured using patient-administered generic (SF-36) and disease-specific (WOMAC) questionnaires as well as objectively assessed balance-ability (Biodex-Balance-System). Measurements were taken one day before the Total-Hip-Replacement and 10 days, 4 and 12 months following. Treatment-effect was determined pre-operatively with t-test and post-operatively with analysis-of-variance as well as effect-size. RESULTS: The intervention improved Quality-of-Life (subscale pain; p<0.05) and Sensory-Motor-Function (balance-ability; p<0.05) compared to no intervention before operation. These effects were lost following surgery. The intervention-group estimated Disability (p=0.055) at 4 months more negatively than the control-group. At one-year-follow-up group-membership influenced Quality-of-Life-score (subscales vitality and mental-health; p<0.05) different depending on the measurement-time-point. CONCLUSIONS: No useful effect was identified for a pre-operative sensory-motor training-programme. The intervention appears to have initiated a psychosomatic process. Further studies are needed to assess whether a personalized, ability-specific home-programme would be more effective. The psychological aspects following Total-Hip-Replacement need to be considered in such a training-programme in order to facilitate coping-strategies, reduce unrealistic expectations and increase satisfaction.

Changes in neurophysiologic parameters in a patient with dental anxiety by hypnosis during surgical treatment

It was hypothesized that dental anxiety, which leads to neurophysiologic alterations in heart rate, respiratory rate and blood pressure prior, during and subsequent to dental treatment, can be influenced by medical hypnosis. We report the positive impact from non-invasive hypno-sedation during dental implant surgery on a 54-year-old female patient who experienced neurophysiologic reactions as a result of the psychosomatic process of dental anxiety (dental anxiety scale value = 13). The neurophysiologic changes during dental surgery performed with and without hypnosis were compared after the patient underwent the same surgical treatment protocol. This case report was part of a study designed to evaluate hypnosis as a non-invasive therapy for dental-anxious patients over six sessions using subjective experience and objective parameters, which included electroencephalogram, electrocardiogram, heart rate, blood pressure, oxygen saturation of the blood, respiration rate, salivary cortisol concentration and body temperature.

Building bridges between body and mind: The analysis of an adolescent with paralyzing chronic pain

This paper describes the evaluation, initial psychotherapy and subsequent psychoanalysis of an adolescent who presented with a severe psychosomatic process involving total body pain and profound fatigue. The author details the complex and multifaceted nature of the psychosomatic process as it unfolded in the treatment. The psychosomatic problem was not a single entity, but rather was comprised of diverse interwoven elements such as somatization, conversion on pre‐oedipal and oedipal levels, conflicts over aggression, sexuality, identity, masochism, secondary gain, anaclitic depression, internalized self‐other interactions with a depressed mother and transgenerational transmission of trauma. The author uses the case material to discuss technical approaches to problems that often arise in the analytic treatment of patients with complicated chronic pain and fatigue as the primary complaints. Such approaches include respecting the mind‐body split as a primary defense, speaking the language of the body along with the language of the mind and developing the verbal sphere around the non‐verbal symptoms. The author emphasizes that complicated chronic pain problems are common and can be helped by psychoanalysis as long as the unique and complex features are understood and reflected in the technical approach.

PSYCHOLOGICAL ISSUES IN DIAGNOSIS AND TREATMENT OF ERECTILE DISORDERS

Psychological issues are salient in every case of erectile dysfunction because sexual function is a psychosomatic process. The best overall assessment is made through separate psychosocial interviews of patient and partner. Interview technique requires comfort and a nonjudgmental attitude. A combination of psychological and physiological treatments offer the best outcome for many cases.

BURNING MOUTH SYNDROME

Burning mouth syndrome (BMS) is a frequent process that produces marked oral dysesthetic symptoms. There is controversy over its etiopathogenesis and diagnosis. Therapeutic results are unsatisfactory. The objectives of this study were: (1) to analyze a possible agreement on the definition of BMS; (2) to analyze its cause; (3) to propose a therapeutic scheme that has been shown to be highly effective in our experience and has not been previously reported. Five hundred patients with symptomatology of BMS were retrospectively evaluated with a study protocol, specially designed for this disease. Patients with local or general disease processes that could cause secondary asymptomatic stomatodynia were excluded from the study. Most of the patients evaluated were women over 60 years of age with oral symptoms, including a sensation of heat and burning, and pain, lasting for months or years, and a history of multiple unsuccessful treatments. The patients showed depression associated with anxiety, with evidence of psychiatric disorders in the family. Based on these findings and eliminating symptomatic painful conditions of the mouth that may stimulate this syndrome, we diagnosed a genuine or basic BMS of psychosomatic origin. Therapies used in the treatment of these neurotic conditions were not always useful. Tranylcypromine associated with anxiolytics and hypnotics in low doses plus the support of psychotherapy by the stomatologist were the most effective treatments. The BMS should be defined as a psychosomatic process causing oral dysesthesias for months or years.