Nine patients who habitually ruminated after meals underwent clinical tests and psychological questioning.
An exploration was undertaken of the psychological characteristics of 19 patients with psychogenic voice disorders who failed to respond to standard methods of speech therapy. Excessive anxiety, musculoskeletal tension and difficulties in expressing feelings or being assertive were common, usually associated with unsatisfactory interpersonal relationships, especially with members of the family. Fifteen were offered psychological therapy, 14 being offered joint therapy with a speech therapist and a psychologist employing a cognitive‐behavioural approach. Of the 12 who participated in the co‐therapy programme, six improved both in their voice and psychosocial adjustment.
S Using Freud's hysterical conversion model as a basis for reviewing the psychological features in psychogenic voice disorder, this paper describes research findings which show that individuals with this condition are not usually suffering from severe psychopathology but tend to be women who are experiencing high levels of stress (commonly associated with interpersonal relationship conflicts, low self‐esteem, the burden of responsibility and feelings of powerlessness), and have above‐average musculoskeletal tension as well as difficulties in voicing their feelings or views. The review indicates that the psychoanalytic interpretation of psychogenic voice loss continues to have relevance. However, it is suggested that in most cases Freud's hysterical conversion model should be reformulated, reducing the core focus to unconscious conflicts, repression, denial and secondary gains, in order to emphasise the psychosocial causes and maintenance of intrapsychic conflict and physical dysfunction. It is also suggested that a reformulated psychoanalytic interpretation of psychogenic voice loss has a lot in common with a cognitive–behavioural conceptual model. A psychoanalytic approach may be valuable when focused on early trauma and repressed experiences or feelings, whereas cognitive–behavioural treatment strategies, such as stress management and assertiveness training, appear to be particularly relevant in this condition. The paper concludes by briefly considering some areas of future research. Partant du modèle de conversion hystérique freudien pour passer en revue les facteurs psychologiques des troubles vocaux psychogéniques, nous décrivons les résultats de recherches qui montrent que le plus souvent, au lieu d'être atteints de psychopathologies graves, les individus affectés de cette condition tendent plutôt à être des femmes souffrant de niveaux considérables de stress (ce qui va souvent avec des conflits de relations interpersonnels, à un manque de confiance en soi, à de lourdes responsabilités et à des sentiments d'impuissance); de surcroit ces femmes sont sujettes à des tensions musculo–squelettiques excessives, et elles ont du mal à exprimer leurs sentiments ou leurs opinions. Notre passage en revue indique que l'interprétation psychanalytique de la perte de voix psychogénique est encore valable à l'heure actuelle. Nous suggérons cependant que dans la plupart des cas le modèle de conversion hystérique freudien gagnerait à réajusté, en ce qu'il faudrait réduire l'accent central sur les aspects subconscients des conflits, répressions, refoulements et gains secondaires, et insister sur l'aspect psychosocial des origines et du maintien des conflits intrapsychiques et des dysfonctionnements physiques. Nous proposons également qu'une fois réajustée l'interprétation psychanalytique de la perte de voix psychogénique a beaucoup de points communs avec un modèle conceptuel cognitif–behavioriste. Une approche psychanalytique peut servir si l'on s'intéresse tout particulièrement aux traumatismes et répressions des exp...
We present
UPDATED-March 8, 2019. We report on the design, implementation and evaluation of
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