There are two principal diseases of the colon, or large intestine: mucous colitis and ulcerative colitis. Since both may be produced or aggravated by emotional tension, they are included among the psychophysiologic (psychosomatic) disorders of the gastrointestinal system.Mucous colitis is probably not due to an actual inflammation or infection, as the name implies, but the bowels become highly sensitive and irritable. Among the symptoms are constipation and mucus-containing stools, and the patient complains of indigestion, nausea, stomach distention, poor appetite, and general weakness. These reactions are often erroneously attributed to organic causes, such as gall-bladder disease, prostatitis, appendicitis, and consequently many unnecessary operations have been performed. Spasm-relieving drugs and irrigation of the colon are unlikely to bring lasting relief in persistent cases, since the underlying cause is usually emotional. Psychiatrists believe the condition is a physical reaction to situations that arouse feelings of guilt, anxiety, and resentment, particularly in individuals who tend to be oversensitive and overconscientious. Women are considerably more prone to mucous colitis than men.Ulcerative colitis is a more serious disease, since there is an actual in COLLECTIVE UNCONSCIOUS flammation which produces lesions in the wall of the intestine. The symptoms are acute diarrhea, blood in the stool, intense abdominal pain, weakness, emaciation, and anemia. It is a stubborn disease that calls for close attention of an internist, since it requires a carefully prescribed diet and medications, and in some cases hospitalization and surgery. The patient also needs psychiatric help. During the acute phase of the illness, however, the psychiatrist may merely establish a supportive and protective role with the patient, or advise the internist to do so, since he has a need to be dependent on a strong, understanding person who will accept him as he is.Case histories of patients with ulcerative colitis show that this dependency need was established early in life. Many of them had domineering, hostile, and cold mothers who frustrated their normal desire for protective care. As a result they often felt rejected and reacted with feelings of rage, hostility, and fear of retaliation—and these upsetting emotions disrupted their bowel functions.The early frustrations and conflicting feelings of love and hate toward their mothers are believed to have had a double effect on these patients. First, it became hard for them to establish warm, dependent relationships with other people because they anticipated rejection—yet the need for these relationships remained. Second, they were highly sensitized to any events that threatened their security or self-esteem. In keeping with this tendency their history shows that the colitis attacks frequently set in a short time after a period of intense emotional stress caused by bereavement, disillusionment, rejection, graduation from school (with the necessity of facing a hostile world), or failure at school or at work.The reassurance, support, and protection offered by the psychiatrist often brings about dramatic improvement by itself. Anaclitic therapy, in which the patient is encouraged to regress to helpless, dependent, infantile behavior, has also proved effective in some cases— although extended therapy of this type is often not feasible since the therapist cannot fulfill the patient’s expectations of continuous emotional support. However, many patients respond favorably to intensive psychotherapy that does not attempt deep analysis.Illustrative Case: A man of fifty-five, an efficient carpenter, had symptoms of colitis. He had always been headstrong, rather aggressive, and inclined always to dominate the situation. His wife was completely obedient to him and accepted his verdict in everything. His father’s character had resembled his own, and his mother had accepted all his father’s verdicts. The father was rather strict with the patient and punished him severely when he rebelled, as he often did. He finally left home, chiefly to get away from his father. He later became reconciled with his father, but he himself adopted a similar behavior. When he was about fifty, he found it difficult to maintain his earning capacity and his position in his trade. Although he was not hard up financially, the situation enraged him, and it was during this period that his bowel movements became too frequent and finally colitis developed.This patient had felt dominated, insecure, and unfairly treated in his relationship with his parents. His relationship with everyone else had the same qualities as that with his parents. He solved his conflicts chiefly by assuming a dominant, overbearing, ambitious, superior, self-centered attitude. This carried him along fairly well until his age and the economic depression made it impossible for him to maintain such an attitude successfully. The preference for younger men threatened his whole security system, his method of solving life problems. It was the threat to his overvalued picture of himself that aroused his anger and his anxiety. (Maslow and Mittelmann, 1951)

Cite this page: N., Sam M.S., "COLITIS," in, November 28, 2018, (accessed August 16, 2022).


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