Expression sickness
Expression disease is a psychosomatic disease concept described by Thure von Uexküll in 1963 .
definition
The concept of expressive diseases as a generic term in the psychosomatic system states that such socially sanctioned facts that cannot be formulated verbally consciously or without social disadvantages and implemented in targeted actions by an individual in the event of a conflict, on a physical level with the help of " Body language ”or other conspicuous features that have a demonstrative effect can be“ expressed ”symbolically. The sanctioned behavior is not carried out, but instead a “ action fragment ”, cf. also the linguistic derivation of the concept of symbol . The conflict, initially perceived as a disorder , is somatized . The prototype of the expression disease is the conversion described by Freud . Most of the time, the cause is a conflict between the behavior that is morally required by society or the close family environment, which, however, is not approved by the person concerned and is in contradiction with the goals desired by him. Since verbal protest seems hopeless, a certain physical expression behavior, which is also to be understood as protest, represents a compromise between the socially required adherence to principles and the motivation pursued by the individual . Expression diseases are differentiated by von Uexküll from the diseases of readiness . For the psychological basis of this concept outside of psychoanalysis, see the term expression psychology .
The dichotomy of the disease economy
According to metapsychological principles, the protest against the social convention allows a certain prospect of subjective success, at least through the primary gain from illness that has to be taken into account . On the other hand, the behavior of individuals, which is more or less easy to understand, is consistently referred to as “abnormal”, “pathological” in a pejorative sense or even stigmatized as “mentally ill” by representatives of the social observance of standardized motivations . Accordingly, in the terminology of psychoanalysis, it is a question of a conflict between the ego and the superego . The concept is still relevant today. According to the psychoanalytic view, mental energy is partially withdrawn from the cathexis of the object . There is a partial displacement . Correspondingly, an action fragment (see above) or an affect correlate is also spoken of. Sigmund Freud spoke of 'incomplete conversion'.
Symptoms
The physical symptoms are an expression of the affected ego. This can be traced back to everyday expressions such as B. ' I' feel paralyzed . The symptoms of the expressive diseases clearly demonstrate the underlying conflict with the social environment due to non-organic paralyzes, language disorders, facial expressions and gestures, emotional, hearing or visual disorders, etc. According to Franz Alexander, it primarily affects organs with striated muscles .
Examples
Examples of expressive disorders are: hysteria , war tremors , motility psychoses . Here there are persistent somatic findings, while the vegetative symptoms, which may be observed in patients with hysterical paralysis, etc., are not permanent.
Special forms
The affected person is at least partially aware of expressive diseases in their affective genesis, but the conscious personal motivations are subject to repression in the disease symptom itself . However, there is still a positive affect correlate . As a secondary expression disease according to the theory of George L. Engel (1913–1999) et al. a. is a somatopsychic disorder in which an existing physical damage takes on a secondary meaning. It is questionable that it also aims at secondary gain in disease. From these “expressive diseases” von Uexküll differentiated the willingness diseases that go hand in hand with no successful, conscious processing of conflicts and in which the conflict-prone motives are largely suppressed or not learned.
See also
Individual evidence
- ↑ a b c d e f Thure von Uexküll : Basic questions of psychosomatic medicine. Rowohlt Taschenbuch, Reinbek bei Hamburg 1963, (a) Overview of all tax information on "expressive diseases", pp. 150 ff., 155, 158, 165, 172, 194, 197 f., 201, 203 ff., 233; (b) on Stw. “Expression and Symbol Character”, p. 85; (c) re. “Incomplete conversion”, p. 204; (d) re. “Symptomatik”, p. 198; (e) to Stw. “Vegetative Symptoms in Hysterical Paralysis, etc.”, p. 198; (f) Re. “Secondary gain from illness”, p. 197.
- ↑ a b c Sven Olaf Hoffmann , G. Hochapfel: Theory of Neuroses, Psychotherapeutic and Psychosomatic Medicine. Compact textbook. 6th edition. Schattauer, Stuttgart 2003, ISBN 3-7945-1960-4 ; (a) Re. “Topicality of the Concept of Expression Diseases”, pp. 202, 204, 218; (b) re. “Quergestraubte Muskulatur”, p. 304; (c) Re. “Secondary expression disease”, p. 204.