PSYCHOPHYSIOLOGIC DISORDERS (GENERAL)

Disturbances in the function or structure of a bodily organ resulting from prolonged emotional stress. The symptoms are physical (somatic) and are produced in the main by overactivity of the autonomic nervous system, the system which controls the visceral and skeletal changes associated with emotions such as fear and anger The current interpretation of psycho- physiologic disorders is based on the fact that when an individual has difficulty adapting to situations and solving his psychological problems, he may be thrown into a state of tension and emotional excitement. If this state is prolonged, the usual physical changes that accompany emotion—increased blood pressure, digestive upsets, rapid breathing, pale or flushed skin, etc.— become chronic and lead to definite organic symptoms. Different individuals tend to develop different disorders, such as peptic ulcers, migraine, or asthma.These disorders have recently been reclassified by the American Psychiatric Association and brought under the heading “Psychophysiologic Autonomic and Visceral Disorders” instead of the broader designation “Psychosomatic Disorders.” The term “psychophysiologic” is used because these disorders are physiological in nature but precipitated by psychological factors. The Association has grouped them according to the body system affected, and the following list contains the major reaction types, although it is not meant to imply that every case of hives, etc. is emotionally produced. Those discussed as separate topics in this book have been capitalized. Most of the others are listed in the Index and mentioned under other topics.Skin Reaction: neurodermatitis, hives, acne, allergic eczema. Musculoskeletal Reaction: Arthritis,Tension Headache, backache, muscle cramps, psychogenic heumatism.Respiratory Reaction: Asthma, Breath Holding, Common Cold, Hyperventilation Syndrome, tuberculosis, hay fever, sinusitis, recurring bronchitis.Cardiovascular Reaction: Hypertension, Raynaud’s Disease, Migraine, tachycardia (excessive heart action), vascular spasm, coronary disease, anginal syndrome. See Illustrative Case, PSYCHOPHYSIOLOGIC DISORDERS (ETIOLOGY AND THERAPY).Hemic and Lymphatic Reaction: Disturbances in the blood and lymph systems, such as anemia.Gastrointestinal Reaction: Anorexia Nervosa, Colitis, Peptic Ulcer, Bulimia, constipation, gastritis, hyperacidity, “heartburn.”Genitourinary Reaction: Frigidity, Impotence, Menstrual Disorders, Menopause, False Pregnancy, Infertility, painful urination, vaginismus, urethritis.Endocrine Reaction: Diabetic Reactions, Obesity, hyperthyroidism.Nervous System Reaction: Asthenic Reaction (Neurasthenia), Phantom Reaction, Anxiety Reaction, certain convulsive disorders, body image disturbance.Organs of Special Sense: conjunctivitis, glaucoma, photophobia; disorders of hearing, taste, smell. See BLINDNESS, DEAFNESS, SENSITIVITY DISTURBANCES.The recognition that mental and emotional factors can play a major role in organic illness has given rise to the psychosomatic approach. This is a comprehensive, “holistic” point of view which holds that the patient’s tensions, life situation, and attitudes may be directly related to the symptom picture and the course of illness. It advocates treating “the person, not the disease,” and maintains that it is often “more important to know what kind of patient has the disease than what kind of disease the patient has” (Dunbar, 1943). This approach applies not only to the specifically psychophysiologic disorders which are brought on by emotional factors, but to diseases which are primarily physical such as pneumonia and tuberculosis. The role played by emotions in the onset and course of these diseases will be discussed under the topic