Success of cathartic therapy as a function of patient variables

Treated sample of 42 patients with cathartic psychotherapy and evaluated differential effectiveness on types of patients. Patients without mental disorders experienced more emotional catharsis than all others, and those with obsessive compulsive personality disorders improved more than all others as a result of emotive treatment. Contrary to popular notions, neither women nor hysterics experienced more catharsis or improved more in cathartic therapy. Although women and hysterics may cry more easily in daily life, obsessives are apparently more able to maintain focus on unhappy experiences and are therefore able to express more emotion in cathartic therapy. Furthermore, it seems that cathartic treatment is beneficial by disrupting long-standing defenses against emotional experiences, rather than by releasing stored-up affects.

Hypnosis and related clinical behavior

The essential aspect in the experience of the hypnotized person is the altered or distorted perception that is suggested to him. Not all people are capable of the experience, but it is possible that spontaneous distortions occur in those with high hypnotizability. These distortions are frequently experienced as frightening symptoms. The author draws attention to the similarity between hysterical symptoms and events in hypnosis and to the high hypnotic responsivity in hysterical subjects reported in the clinical literature of the nineteenth century. Phobic patients have relatively high hypnotic responsivity. The author believes that it is sometimes possible to predict hypnotizability from clinical behavior, and that hypnotic responsivity can be utilized in psychodynamically sensitive therapy to teach such patients that they can learn to gain control of their symptoms.

[Medications during psychotherapy (author's transl)]

The report is on medication in a specialized clinic for psychotherapy. The most important findings are the following: 1. The medications in the clinic in question are not more numerous than they are "on the outside" (=per capita consumption in the case of members of the compulsory health insurance); 2. personality sumptoms have great influence on the frequency of medicine given: older patients receive more medication than younger ones, women more than men. Obsessionally structured patients receive noticeably less medicine than the hysterically or depressively structured ones; 3. symptomes hardly have any influence: no decrease during the second half of therapy, no dependence on any fixed day of the week and the therapy hour. It is therefore concluded that with a totally smaller quantity the medications in the clinic in question show autonomy: they have evidently no direct relation to the psychotherapeutical course of treatment.

Neurogenic and hysterical seizures in children and adolescents: differential diagnostic and therapeutic considerations

For patients whose seizures are not controlled by medication alone, psychotherapeutic intervention can sometimes play a useful adjunctive role in both differential diagnosis and treatment. Diagnostic issues include the differentiation between neurogenic and hysterical seizures as well as the delineation of the possible role of psychogenic stress in triggering neurogenic seizures. Therapeutic considerations focus on the alleviation of precipitating stresses as well as the development of a sense of mastery in the patient.

A review of malingering and hysteria in clinical practice

Hysteria and malingering, both commonly seen, especially in orthopaedic clinics, are reveiwed. Advances in psychology and psychiatry are often unknown or ignored by surgeons, who may thus mistreat or misdiagnose a multitude of conditions.

[Acupuncture and psychiatry. Preliminary note]

Personal experience with acupuncture as a therapeutic technique in psychiatry is presented. Its effects on the patient and the taking of drugs are discussed. The results, like those reported by Chinese and other Italian workers, were encouraging and indicate that the technique may be more widely adopted in this field.

Premature interruption of psychotherapy: continuation of contact by telephone and correspondence

The author collected data on 15 patients for whom therapy was interrupted because of a move to a distant city by the analyst or the patient. He found that 14 of these patients refused to accept transfer to another analyst as urged by their analyst; instead, they continued contact by phone and/or correspondence with the analyst for long periods of time. Continuation of contact was not related to diagnosis but perhaps to a basic inability of these patients to face and work through separation or to some type of special patient-therapist relationship.

Group therapy for patients with hysteria (Briquet's disorder)

It was found that group therapy helped patients with hysteria by (1) satisfying their need to talk (2) lessening their concern about their physical symptoms (3) giving them important knowledge of the illness (4) giving them new ways of handling the illness by themselves (5) giving them the support and the companionship of the other group members (6) reducing their need of medicines (7) reducing psychiatry visits (8) helping them to get along better with their families (9) increasing their self-confidence and (10) improving their mood.

A dialogue with Mandeville

In A Treatise of the Hypochondriack and Hysterick Passions published in 1711, Bernard Mandeville, writing by way of Information of Patients' describes three dialogues between an imaginary physician, Philoperio, and his patient, a confirmed hypochondriac, Misomedion. The book is original in its conception inasmuch as it represents an early recorded conversation between a physician and his patient. As such it represents a development in the writing on therapeutic technique of the eighteenth century. Though Mandeville's originality has been emphasized by contemporary medical historians, this book seems to have had little influence on the therapeutic style of the physicians of his day.

The management of chronic hysteria: a review and double-blind trial of electrosleep and other relaxation methods

The effectiveness and mode of action of electrosleep therapy in chronic hysteria was evaluated in a double blind trial with a 1 month follow-up. Matched groups of hysterics were treated with central electrical stimulation and relaxation, peripheral electrical stimulation and relaxation, or relaxation only. Autogenic training exercises were used initially to standarize the relaxation instructions for all the patients. Central electrical stimulation has no specific benefit for hysteria. Rhythmic peripheral stimulation does increase the effect of verbal suggestions to relax initially but has no long term advantage over relaxation alone. Regular brief periods of relaxation can improve the mood and diminish the anxiety level of psychiatric outpatients with hysteria but have no persistant benefit for sleep disturbance or hypochondriasis. The best treatment of depression in chronic hysterics was found at follow-up to be relaxation without electrostimulation. Specialized somatic and psychotherapeutic methods have no advantage over treatment with low doses of anxiolytic drugs, reassurance, suggestion, and regular periods of relaxation.

Management of children with non-organic (hysterical) disorders of motor function

Five children aged between 10 and 13 years are discribed whose disorders of motor function were found to have a non-organic (hysterical) cause. In most cases extensive investigations had been made to establish an organic cause before the hysterical basis was diagnosed. The three essentials of management of such cases are to limit further investigations to the essential minimum, to institute quickly a programme of graduated physical rehabilitation, and to establish and treat the underlying psychological problems.

[Hysteria, hypnosis and psychopathology. Unknowns and perspectives]

The author, drawing on his wide experience, discusses a number of theoretical questions associated with the subject of practical work. He presents several concepts in connection with the description of a particular case and also discusses various historically important points of view made known through publication in the literature.

Behavioral treatment of hysterical neurosis: symptom substitution and sympton return reconsidered

One of the major areas of disagreement between therapists working within the psychodynamic and behavioral frameworks involves the issues of symptom substitution and symptom return, the psychodynamicists holding that treatment of symptoms alone cannot result in permanent improvement, and the behavioral therapists arguing that it can. However, a reexamination of the data indicates that psychoanalysts base their conclusions primarily on cases of hysterical neurosis whereas the behaviorists base their conclusions primarily on the treatment of phobia. Heeding the call of the recent American Psychiatric Association Task Force on Behavior Therapy (1973), in this paper we seek to reconcile the apparently contradictory data, illustrating our arguments with case reports. Moreover, we will attempt to obtain a greater degree of rapprochement and cross-fertilization between the dynamic and behavioral schools of thought.