Holy Seven

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Holy Seven - German "holy seven (diseases)" - was the classic catalog of seven psychosomatic diseases that were described in 1950 by Franz Alexander . The term holy seven was created later, however, because Alexander assumed “specific conflicts” with these diseases and believed that with each of these diseases he had found typical characteristics for a very specific personality type . Today, this question is connected with the assumption of a certain psychodynamics in psychosomatoses , such as that in essential hypertension or with questions about a differential typology .

Catalog

These seven diseases were:

  1. Ulcus ventriculi (stomach ulcer) and ulcus duodeni (duodenal ulcer)
  2. Bronchial asthma (bronchial asthma)
  3. Rheumatoid arthritis (chronic polyarthritis)
  4. Neurodermatitis (skin disease)
  5. Essential hypertension (high blood pressure)
  6. Hyperthyroidism (overactive thyroid)
  7. Ulcerative colitis , Crohn's disease ( inflammatory bowel disease )

Some authors also count migraines among the Holy Seven of psychosomatoses .

Specific conflicts

The assumption of seven specific diseases could not be confirmed in a strict manner, since the typification of the personality is not precise enough in each individual case to take into account all individual characteristics. Psychology cannot dispense with the assumption of legal relationships, but it is mainly to be understood as an idiographic science, that is, as research that lives from the representation of individual cases. The assumption of seven personality types as psychologically "legal" is unlikely because every system has something arbitrary. The rapidly growing number of psychosomatoses has made this assumption seem rather improbable. The term "Holy Seven" suggests a rather critical attitude towards Alexander's theory, as it suggests less of a scientific thesis than of a fact of faith . A number of popular opposition to psychoanalytic interpretation are related to these facts. Thure von Uexküll himself reports on a personal encounter with Alexander, during which he was very surprised by one of his interpretations of a particular case of illness. However, this interpretation later proved to be correct.

In the run-up to Alexander's investigation, Helen Flanders Dunbar (1902–1959) saw life-historical events, especially in early childhood, as essential for the development of character traits as early as 1935 . Even then, she took a number of the above seven illnesses as an example to explain the causative psychogenic disease factors. So far there had been no physical evidence for this. Dunbar himself warned against rash generalizing their personality profiles. Such personality profiles were used in the 1950s, for example. a. gained from the model concept of manager's disease .

The assumption of specific conflicts that led to what Alexander called a vegetative neurosis was again taken up as a concept by Thure von Uexküll. He considered organ-related vegetative disorders to be the effect of uncontrolled permanent stress and referred to them as supply diseases . They are the chronic continuation of the pathodynamics of functional syndromes . The practical difficulties in the diagnostic assessment and systematics of cases that are often seen as evident are based on the fundamental ambivalence of emotionally determining motives that can unfold in opposite directions over the course of the development of the disease, e.g. B. the alleged ambition of gastric patients.

With regard to personality diagnostics, Karl Jaspers described the ideal type of character studies as a “system of all possible sharply defined opposites”. The moderate is also referred to as total or real type or as the mean between the opposing extreme poles.

criticism

In the case of gastric and duodenal ulcers, the bacterium Helicobacter pylori was identified as the cause of the disease in 1982 . It is now believed that this bacterium is the main cause of these ulcers. However, the discovery of physically justifiable disease factors does not constitute an argument against the effective influence of psychological stressors. Such stressors can nevertheless influence the susceptibility to infections. The extent of the influence is, however, controversial and depends on the underlying worldview of the medical practitioner; whether this considers physiological or psychological causes to be predominant in medicine.

The investigation of a very specific control group appeared to be an unexpected event on the occasion of Helen Flanders Dunbar's investigation . This group had been chosen by Dunbar as a counterexample of the sick apparently affected not by psychological but apparently only by physical causes, from whom it was to be assumed that they had come to the hospital by accident. With this group of people who were supposedly “accidentally” ill, she assumed that there were no internal connections with the accident, similar to the proverbial bad luck of people who “had a roof tile falling on their heads”. The control group were patients on a surgical emergency room. However, the result showed that there is a certain group of people who are repeatedly plagued by accidents. A more detailed analysis of the interrelationships then showed that the way in which one emotionally experiences and assesses one's environment and the way in which one reacts to its demands is not indifferent to the likelihood of having an accident or not. Karl Marbe had already found this out in 1926 during his investigations for a transport company in the USA. As a result, the number of accidents at this company could be reduced to a fifth after drivers who had previously caused accidents there were employed elsewhere.

The intention is not to give the impression that it is a generally accepted theory. The assessment as psychosomatic depends on the attitude of the respective scientist, which aspect he prefers. The scientific approach often favors somatic rather than psychological aspects. In most cases, however, pathogenetic considerations are a multitude of factors that must not be absolutized in a reductionist manner.

Web links

Individual evidence

  1. ^ Franz Alexander : Psychosomatic medicine . Its principles and applications. Norton, New York 1950, 300 pages, DNB-online, German "psychosomatic medicine". Basics and areas of application. De Gruyter, Berlin 1951.
  2. ↑ a b c d e Thure von Uexküll : Basic questions of psychosomatic medicine. Rowohlt Taschenbuch, Reinbek bei Hamburg 1963, on “Specific Conflicts”: pp. 54–63, 69; on taxonomy “Psychology as idiographic science”: p. 54; on “Flanders Dunbar”: pp. 50 ff., 57, 63, 276.
  3. ↑ a b c d Sven Olaf Hoffmann , G. Hochapfel: Theory of Neuroses, Psychotherapeutic and Psychosomatic Medicine. 1999, Compact textbook, Schattauer, Stuttgart 2003, ISBN 3-7945-1960-4 ; (a) on tax authority “Psychodynamics in essential hypertension”: p. 312 ff .; (b) Re. “Holy Seven” p. 304; (c) Re. “Permanent vegetative stress” p. 304; (b) Re. “Avoiding reductionist absolutizations” p. 304.
  4. ^ Wilhelm Windelband : History and Science . Strasbourg: Heitz, 3rd edition 1904. online .
  5. ^ Helen Flanders Dunbar : Emotions and Bodily Changes . (1935) New York edition 1955; Mind and Body: Psychosomatic Medians. New York 1954.
  6. ↑ Karl Jaspers : General Psychopathology . 9th edition, Springer, Berlin 1973, ISBN 3-540-03340-8 , 2nd part: Understanding psychology ; Chapter 4: Characterology; § 4 attempts at characterological basic classifications; b) Ideal types, p. 363 f.
  7. ↑ MP Manns: gastric, intestinal and liver diseases. In: Martin Wehling (Ed.): Clinical Pharmacology. Georg Thieme Verlag, 2005, ISBN 3-131-26821-2 , p. 201 limited preview in the Google book search
  8. ↑ G. Guo, KR Jia, Y. Shi, XF Liu, KY Liu, W. Qi, Y. Guo, WJ Zhang, T. Wang, B. Xiao, QM Zou: Psychological stress enhances the colonization of the stomach by Helicobacter pylori in the BALB / c mouse. In: Stress (Amsterdam, Netherlands). Volume 12, Number 6, November 2009, ISSN  1607-8888 , pp. 478-485, doi : 10.3109 / 10253890802642188 , PMID 20102319 .