• Title/Summary/Keyword: Therapeutic alliance

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Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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A Discovery of the Creative Healing Properties in the Unconscious of Alcoholics: From the Perspective of Analytical Psychology (알코올 중독에서 발견되는 무의식의 창조적 치유 활동: 분석심리학의 관점에서)

  • Kihong Baek
    • Sim-seong Yeon-gu
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    • v.39 no.1
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    • pp.129-183
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    • 2024
  • This study is an attempt to get closer to the psychological truth of alcohol addiction. After reviewing previous related studies, the experiences of Korean alcoholics were examined, encompassing both the conscious and unconscious aspects. In order to approach the unconscious, the researcher paid attention to the series of dreams that the patients reported, from the perspective of Jungian dream analysis. Working with dreams brought considerable benefits in increasing patient's involvement in the therapeutic process and fostering therapist-patient alliance. It also helped to understand patients' conscious and unconscious aspects further. The results were as follows. On the conscious level, patients showed a long-standing alienation from their true emotional needs, a lack of sufficient experience in genuinely expressing and being accepted with one's own emotion, resulting in the need for emotional re-experience, along with the intense longing for maternal affection. This also meant that they were in need for maternal re-experience, and at the same time, for the associated paternal re-experience. Furthermore, the researcher identified that certain powerful archetypal complexes had been activated in the patient's unconscious in response to their conscious situations, triggering the destructive shadows to emerge and exert a strong influence on their conscious lives. The series of reported dreams shows how the unconscious always properly and diligently compensates, modifying the perspective and attitude of the conscious and gradually opening the doors to healing, even for alcoholic patients. This indicates that the unconscious carries out a specific and consistent guidance role so the conscious can realize and adequately respond to it, and that it also provides the creative force for transforming the conscious life. These findings suggest that alcohol addiction is a psychological condition that can jeopardize one's life by allowing the powerful energy of the unconscious to penetrate the conscious, but at the same time, have the purpose and direction to urge the creative transformation of one's conscious life. From these results, it can be concluded that the first step towards true recovery is for the individual to turn their attention towards the psychological truth occurring within themselves. In this regard, the therapist's role is crucial. This also suggests that various attempts in the field of addiction treatment will blossom their real values when they contribute, directly or indirectly, to the development of one's self-awareness since as long as one continues to turn away from the psychological truth and persist in craving for false objects, their creative healing properties in the unconscious could rather have negative and destructive impacts on their life.