A Study of the Psychodynamics of Duodenal Ulcer Exacerbations

Abstract

Six male patients with duodenal ulcer were studied with psychoanalytic and psycho-therapeutic interviews in order to elicit the concomitant psychological factors at times of exacerbations. The ulcer symptoms recurred most often when the threat of depletion exceeded the promise of replenishment and the resulting angry protest was restrained. The specific psychosomatic formulation was defined in terms of the nuclear conflict, basic emotions, special ego defenses and interpersonal relationships. No single psychological factor accounted for the exacerbations. The meaning of specificity was considered as a problem of stress and adaptation. Various types of specificity were distinguished, as well as the logical conditions for each. The psychodynamic observations were applied to the problem of managing ulcer recurrences.