Selbstbeschädigung: Psychoanalyse artifizieller Krankheiten

Plassmann, Reinhard

doi:10.1007/978-3-642-75570-5_7

Cited by 5 publications

(10 citation statements)

References 3 publications

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“…sexual experiences, medical procedures performed on the pa tient's body, object losses) activate pathologi cal zones in the body self and the fantasies fix ated there. During a kind of prodromal phase [65], these contents, which have been uncon scious up to now, can still be fended off. i.e.…”

Section: Pathogenesis and Psychodynamicsmentioning

confidence: 99%

“…These patients are very susceptible to sacrificial enactments in which the 'evil' or gan is removed from the body and only the 'good' organs remain. The 'good hand' of one patient surgically removed a fingernail from the 'evil hand' at night, for example, because the latter was hurting [65], In addition, parts of the body which normally relate to each other in an active-passive manner (e.g. handmount, hand-skin, hand-wound, hand-geni tals, mouth-finger, etc.)…”

Section: Pathogenesis and Psychodynamicsmentioning

confidence: 99%

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Münchhausen Syndromes and Factitious Diseases

Plassmann¹

1994

Psychother Psychosom

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Section: Pathogenesis and Psychodynamicsmentioning

confidence: 99%

Section: Pathogenesis and Psychodynamicsmentioning

confidence: 99%

Münchhausen Syndromes and Factitious Diseases

Plassmann¹

1994

Psychother Psychosom

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“…Increased number of chronic physical diseases [EckhardtHenn, 1992;Feldman et al, 1996;Plassmann, 1993;Kapfhammer et al, 1998]. Frequent alcohol abuse in the family.…”

Section: Biographical Dispositionmentioning

confidence: 99%

“…In 50-70% of the patients, repeated traumatizing experiences (like sexual and physical abuse and deprivation situations) and social stress (poor financial situation of the family, etc.) in the history [Eckhardt-Henn, 1992Plassmann, 1993;Feldman et al, 1996;Feldman and Ford, 1994;Gieler et al, 1994;Kapfhammer et al, 1998]. …”

Section: Biographical Dispositionmentioning

confidence: 99%

“…Moderate and severe forms: Markedly increased number of general stress factors, such as low economic status, broken relationships, losses, emotional disorders among the parents [Feldman and Ford, 1994;Plassmann, 1993;Feldman et al, 1996;Kapfhammer et al, 1998;Eckhardt-Henn, 1994]. Increased number of chronic physical diseases [EckhardtHenn, 1992;Feldman et al, 1996;Plassmann, 1993;Kapfhammer et al, 1998].…”

Section: Biographical Dispositionmentioning

confidence: 99%

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Factitious Disorders

Gieler¹,

Eckhardt-Henn²

2004

Dermatol Psychosom

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Definition, Classification, Descriptive Dimensions Factitious disorders are found less often in primary care than in specialized hospitals and large clinics; on principle, factitious disorders occur in all outpatient areas; para-factitious disorders such as manipulations with insulin by diabetics are found more frequently. Epidemiological data have not yet been confirmed by studies with larger patients’ samples because of disorder-specific problematics. Current prevalence estimates range between 0.05 and 2.0%. Patients with factitious disorders have traditionally been viewed as difficult (‘problem patients’) and little motivated for psychotherapeutic/psychosomatic therapy. Factitious disorders (ICD-10: F 68.1) are defined as self-injuring acts which directly or indirectly result in objectifiable clinically-relevant damage to the organism, without direct intention of suicide. The injurious or illness-inducing act is performed in secret. For outsiders, the relationship between the clinical finding and the patient’s causing or inducing activity is not readily apparent. The self-injuring act is targeted and consciously controlled but often performed in dissociative states, and the patient cannot always remember the act or the emotional state. The patients’ initial goal is hospital admission and medical, sometimes even invasive measures, e.g. surgical. The motivation for the behavior is initially unclear and arises for inner-psychic or even social reasons. A factitious disorder is also present if a patient injures himself by causing a doctor to initiate surgical procedures or invasive or other risk-laden diagnostic measures either by giving misinformation or by malingering. Open self-injuring behavior (cutting, stabbing, burning oneself, etc.) is not unusual in patients with factitious disorders in the course of the disease, sometimes it replaces secret self-injury and represents a transitional phase before the self-injuring behavior can be completely given up. ...

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Der Stellenwert des Bauchgefühls als Warnsignal für Fehldiagnosen im Psychosomatischen Konsil

Seidl

Schwerthöffer

2021

Psychother Psychosom Med Psychol

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Zusammenfassung Hintergrund Der Psychosomatische Konsiliardienst bietet die Möglichkeit zur Korrektur von Fehldiagnosen. Die nicht-analytischen, erfahrungsbasierten Bauchgefühle des Arztes spielen dabei als diagnostische Wegbereiter eine wesentliche Rolle. Methodik In einer Fallserien-Studie wurden die Abläufe von 165 psychosomatischen Konsilen und die dabei im Konsiliarius auftretenden emotionalen und kognitiven Prozesse erfasst. Der diagnostische Prozess wurde unter Bezugnahme auf die duale Prozesstheorie analysiert. Beim Bauchgefühl wurde zwischen einem sense of alarm und einen sense of reassurance unterschieden. Exemplarisch wurden bei vier Konsilen die Prozesse dargestellt, die zur Aufdeckung von Fehldiagnosen führten. Ergebnisse In 24 Konsilen (16%) wurde eine Fehldiagnose festgestellt. Anlass hierfür war immer ein sense of alarm, der sich in 29 von 165 Konsilen (18%) einstellte. In 11 Konsilen (7%) bestand ein sense of reassurance, der in zehn Konsilen mit einer Bestätigung der Diagnose assoziiert war und nur in einem Fall einem sense of alarm wich und zu einer Diagnosekorrektur führte. SchlussfolgerungenDie Beachtung des Bauchgefühls und seines sense of alarm ist eine effektive Methode, Fehldiagnosen zu erkennen. Ausbildungsprogramme sollten nicht nur das rational-analytische Denken, sondern auch die selbstkritische Introspektionsfähigkeit des Arztes fördern.

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Selbstbeschädigung: Psychoanalyse artifizieller Krankheiten

Cited by 5 publications

References 3 publications

Münchhausen Syndromes and Factitious Diseases

Münchhausen Syndromes and Factitious Diseases

Factitious Disorders

Der Stellenwert des Bauchgefühls als Warnsignal für Fehldiagnosen im Psychosomatischen Konsil

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