par Cosyns, Simone 
Référence Acta psychiatrica Belgica, 75, 4, page (425-438)
Publication Publié, 1975
Référence Acta psychiatrica Belgica, 75, 4, page (425-438)
Publication Publié, 1975
Article révisé par les pairs
| Résumé : | The therapeutic approach in psychosomatic medicine requires the somatician to keep psychological factors in mind and the psychiatrist to consider the somatic complaint. The therapeutic attitude will be different according to the psychofunctional problem or an authentic psychosomatic disease. However, in every case, the patient must be considered in totality and a good doctor patient relationship must be established. The doctor can then better understand the emotional and intellectual aspects of his patient and therefore plan his therapeutic program: reducing the anxiety by explaining to the patient the possible correlations between his complaints and emotional factors; adopting a supportive attitude; offering the patient the possibility to explain verbally certain repressed ideas (ventilation psychotherapy); manipulating, if necessary, the milieu in which the patient lives (treatment centered on the environment); starting a deep rooted psychotherapy in certain cases. The problem of psychosomatic diseases in gastro enterology, like duodenal ulcer and hemorragic ulcerative colitis, is discussed in detail. Concerning duodenal ulcer, one can distinguish between two levels of psychotherapy: psychological approach for the gastro enterologist with a proper background in the psychological approach to patients; and psychotherapy. The treatment of this disease is always multidimensional utilizing both psychological and drug treatment. Concerning hemorragic ulcerative colitis, supportive psychotherapy is crucial during the acute phase. It takes effect by an entire affective relationship with the patient and the entire therapeutic team. During a remission the therapist must provide the patient with the type of relationship he desires, and be available to the patient. In some cases, a deep psychotherapy should be used, even in conjunction with somatic care. |
