Observation 5 : Monsieur Gilbert C.

Marty, Pierre; M’Uzan, Michel de; Dávid, Christian

doi:10.3917/rfps.035.0077

Cited by 7 publications

(7 citation statements)

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“…It thus appears that the biomedical model underlying much of the modern approach to disease makes it difficult for clinicians to imagine that a florid condition such as chronic urticaria, associated with obvious mast cell mediator release and effects, and clearly visible to the evidence-oriented eye, can really have its origin (partly or solely) in psychological factors. Amazingly, a review article on psychodermatology37 does not even mention CSU, despite holding a strong psychological orientation to skin conditions, and even subscribing to the view that a skin symptom can be seen as a ‘coded message’ 38…”

Section: Medical Dualism and Organicitymentioning

confidence: 99%

A reappraisal of the role of ‘mindbody’ factors in chronic urticaria

Broom¹

2010

Postgraduate Medical Journal

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Chronic spontaneous urticaria (CSU) is a very common skin condition that causes considerable suffering and is often poorly responsive to drug treatment regimens. Most clinicians accept that multiple factors play a role in the aetiology of CSU, but there is a widespread reluctance to accept a significant role for 'mindbody' factors, despite a large number of clinical reports and studies over many decades suggesting their relevance. This reluctance has multiple origins. A primary influence is the flawed dualistic model of mind and body relatedness underpinning much of modern medical care. In this view, if a pathophysiological mechanism can be discerned, then 'mind' factors can be largely ignored. Recent evidence demonstrating intimate structural and functional relations between peripheral nerves and mast cells, and local skin secretion of mast cell-influencing neuropeptides by nerves, provides an argument for discarding old 'organic' and dualistic conceptualisations of CSU. A sound, integrative, multifactorial approach requires a unitive 'mindbody' model in which physical and subjective dimensions of personhood are seen as coexisting and equally deserving of exploration and management. Another influence is the tendency for 'psychosomatic' research studies in CSU to focus on patient experience using broad group-based diagnostic categories, such as anxiety and depressive disorders, and generic measures of stress. Two case examples are given, illustrating that CSU arises in relation to highly individual and relevant 'stories', which would not usually be picked up by these generic measures. It is suggested that an appropriate 'mindbody' management programme leading to good clinical outcomes for CSU is dependent on clinicians discerning unique patient 'stories'. Finally, a lack of formal studies comparing drug and 'mindbody' treatment outcomes will continue to negatively influence the adoption of 'mindbody' approaches in CSU. There is an urgent need for properly structured comparative studies, and the essential elements of a suitable 'mindbody' approach appropriate to such research are briefly outlined.

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Section: Medical Dualism and Organicitymentioning

confidence: 99%

A reappraisal of the role of ‘mindbody’ factors in chronic urticaria

Broom¹

2010

Postgraduate Medical Journal

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“…While the neurotic patient would use psychic defenses that can help him to reduce the anxiety-inducing tension produced by unconscious conflicts, the psychosomatic patient would lack the capacity to symbolize, thus using its body for discharging internal tensions. In 1963 Marty and de M’Uzan delineated therefore the psychosomatic personality as characterized by an attitude of hyper-normality, with a conformist adaptation to the environment and social needs, and a particular cognitive style called “operational thinking” ( pensèe operatoire ) 6 . The operational thinking is characterized by a number of deficit.…”

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confidence: 99%

Alexithymia and personality traits of patients with inflammatory bowel disease

Barbera

Bonanno

Rumeo

et al. 2017

Sci Rep

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Psychological factors, specific lifestyles and environmental stressors may influence etiopathogenesis and evolution of chronic diseases. We investigate the association between Chronic Inflammatory Bowel Diseases (IBD) and psychological dimensions such as personality traits, defence mechanisms, and Alexithymia, i.e. deficits of emotional awareness with inability to give a name to emotional states. We analyzed a survey of 100 patients with IBD and a control group of 66 healthy individuals. The survey involved filling out clinical and anamnestic forms and administering five psychological tests. These were then analyzed by using a network representation of the system by considering it as a bipartite network in which elements of one set are the 166 individuals, while the elements of the other set are the outcome of the survey. We then run an unsupervised community detection algorithm providing a partition of the 166 participants into clusters. That allowed us to determine a statistically significant association between psychological factors and IBD. We find clusters of patients characterized by high neuroticism, alexithymia, impulsivity and severe physical conditions and being of female gender. We therefore hypothesize that in a population of alexithymic patients, females are inclined to develop psychosomatic diseases like IBD while males might eventually develop behavioral disorders.

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“…As an individual difference, alexithymia overlaps conceptually with the emotional intelligence construct, which encompasses the ability to perceive and appraise one's own and other's feelings and emotions, the ability to access and use feelings to guide one's thinking and action, and the ability to regulate emotions to promote emotional and intellectual growth (Mayer and Salovey, 1997). As characteristics of alexithymia include externally oriented thinking and avoidance of confronting emotion, and as these patients are reluctant to engage in a therapeutic process based on verbal thoughts and could present a risk of somatization when involved in the therapeutic process (Marty, De M'Uzan and David, 1963), it is necessary to develop alternative therapeutic approaches. Considering that the restricted imaginal capacities of alexithymic people limit the extend to which they can modulate negative emotions by imaginative activities that have positive connotations, such as fantasy, dreams and play (Krystall, 1988), an approach based on imagery could be an interesting alternative, in order to accelerate the use of imagery with positive connotations, to accelerate mild confrontation to negative emotions and to reframe those emotions.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an hypnotic imagery intervention on reducing alexithymia

Hanin¹,

Luminet

2008

Contemporary Hypnosis

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The therapeutic potential of the use of mental representations, such as mental images, might be an interesting approach in the treatment of people who are severely impaired with respect to the processing of emotion, and in particular the activation of mental images. That is the case of alexithymia, which is a multifaceted construct comprising (a) diffi culty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal; (b) diffi culty describing feelings to others; (c) a restricted imagination, as evidenced by a paucity of fantasies; and (d) a cognitive style that is literal, utilitarian, and externally oriented (Taylor and Bagby, 2000). Thirty-one alexithymic female students were randomly distributed into two conditions: hypnotic imagery condition and control condition. Participants in the hypnotic imagery condition took part in an 8-session individual training programme. The fi ndings indicate that hypnosis is an effective technique for obtaining a decrease in alexithymic scores. The fi ndings also indicate that changes in mood states are not involved in the change in alexithymia scores. This suggests that hypnosis has exerted a direct effect upon alexithymia (not attributable to anxiety or depression), and consequently demonstrates that it is possible to exert an effect (i) upon alexithymia without targeting a decrease in anxiety or depression scores, (ii) upon alexithymic people with no anxiety or depression problems, as anxiety and depression are not the therapeutic determinant of the therapeutic response.

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Observation 5 : Monsieur Gilbert C.

Cited by 7 publications

References 0 publications

A reappraisal of the role of ‘mindbody’ factors in chronic urticaria

A reappraisal of the role of ‘mindbody’ factors in chronic urticaria

Alexithymia and personality traits of patients with inflammatory bowel disease

Effectiveness of an hypnotic imagery intervention on reducing alexithymia

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