Somatotherapy

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Somatotherapy (derived from ancient Greek σῶμα , soma = body, corpse) is a collective name for the physical treatment methods in psychiatry in contrast to psychotherapy . In psychiatry, the term mainly refers to the contrast between body ( res extensa ) and soul ( res cogitans ), or the tension between spirit and physique, stemming from Descartes ' philosophy (1596–1650) .

Somatic (physical) treatment methods are actually common in organ medicine and have "in psychiatry, in a remarkable way, a poorer reputation compared to psychotherapy". T. extremely widespread. In addition to somatotherapy and psychotherapy, sociotherapy is also an important psychiatric treatment method.

theory

Psychophysical correlation or control loop on the animal level . Somatotherapy represents a so-called upward effect .

Physical treatment methods for psychological purposes thus initially appear paradoxical and can only be understood from the idea of ​​a psychophysical correlation (see figure on the right). The basis of this illustration is the philosophical theory of layers . From this point of view, physical causes have necessary psychological effects.

Here, however, the methods desired by the person concerned must be distinguished from those means and ways of physical treatment that are used by society to exclude and protect against the mentally ill. These physical procedures and their physiological or medical-sociological appreciation are found z. In part, it is expressed in the distinction between psychiatric physiotherapy and psychiatric compulsory treatment . It can also be represented in the distinction between positive and negative psychiatric sanctions . Exclusive somatotherapy is the logical conclusion from the ideological attitude of the somatics .

Somatotherapy in psychiatry

Chair to Avoid Restlessness of Movement (around 1824)

Earlier

In medical-historical order, the first somatically founded therapies include the natural-philosophical effects of primary substances such as water, which, as is well known, were already emphasized by Thales von Milet (640-546 BC). Such healing uses of water took place in Epidaurus in ancient Greece. Somatotherapy also had a similar meaning in natural philosophy with Johann Christian Reil , who carried out his first somatic research on the brain, invented the term psychiatry and advocated somatotherapy, but did not have concrete experience with mentally ill people. Under the paradigm of moral treatment , psychiatry did not completely renounce physical influence, as John Connolly had suggested in England with his concept of renouncing mechanical coercion ( no restraint ).

In Germany, ideas about the use of physical measures were particularly irrational (see also Orthopedic Paradigm ). Here especially physical coercive practices were first recorded: straitjacket , forced chair and swivel chair as well as the most compulsory treatment with water (Kraepelinsches heat bath, shower-bath, surprise baths such as baths, which then underwent the patient when he least expected.) . In Germany, Ernst Horn (1774–1848) was still a proponent of such coercive measures. However, Ernst Horn and his successor Karl Georg Neumann (1774–1850) took a critical stance on the medication prescriptions customary in the 19th century in psychiatry.

Physical treatments have gained momentum in psychiatry since the growing influence of the natural sciences. This has been particularly evident since the 19th century. This type of treatment led to shock therapies . More recent empirical-somatic treatment methods are: malaria therapy (1917), sleep cure (1921), insulin shock therapy ( 1933), prefrontal leukotomy (1935), cardiazole shock therapy (1935), electroconvulsive therapy (1938) - also known as electroshock treatment - and psychopharmacotherapy (ab 1952).

today

Most of them are psychiatrically obsolete today or, at least in German-speaking countries, are only a method that is rarely used in psychiatry. The latter applies to electroshock treatment in life-threatening conditions that cannot be influenced in any other way. Their widespread use is otherwise only common in internal medicine as a resuscitation method for acute cardiac arrest. However, an overwhelming exception to this rule is the psychiatric treatment is that has contributed to the widespread use of somatotherapy in psychiatry, although the effect of these drugs is quite non-specific and none of them can lay claim from acting causally. Even if the term “chemical straitjacket” has not come into use for psychotropic treatment without reason, other factors also play a role in the spread of this treatment.

Orthopedic paradigm

In the 18th century, mechanical ideas were not only widespread in psychiatry but also in orthopedics and resulted in the use of such methods in newly established institutions.

In psychiatry, somatotherapy is therefore more of a product of natural philosophical and, last but not least, scientific ideas. They treated mental illnesses B. mechanical, because they were perceived as traumatological or other physically justifiable ailments. Something like that in orthopedics (see the illustration). The wave of founding corresponding orthopedic or psychiatric institutions in the 18th century took place at the same time and was mostly driven by political and economic interests. A generally accepted doctrine of psychic trauma did not yet exist. The case of Daniel Paul Schreber (1842–1911) and the Schreber family demonstrates the excesses of such forms of pseudomoral treatment.

literature

  • Sackler, Arthur & M. Hay: The great physiodynamic therapies in psychiatry . New York 1956
  • Müller, Max: Somatotherapy . Basics and methodology of somatic treatment procedures in psychiatry. Springer, 1963 - 327 pages
  • Ehrenfried, Lily: Physical education for mental balance: Somato therapy, a forgotten healing factor . Berlin-Wilmersdorf, Westl. Berliner Verl.-Ges. Heenemann, 1957
  • Weidtmann, Wilfried: The somatotherapy of endogenous psychoses at the University Psychiatric Clinic Marburg . Marburg, Med. F., Diss. June 27, 1963
  • Schreiber, Ursula: Comparative study of the somatotherapy of endogenous psychoses of the years 1959-1961 and 1961-1965 at the University Psychiatric Clinic in Marburg . Marburg, Univ., Med. Fak., Diss. 1971
  • Hofmann, Norbert R .: Somatotherapy of endogenous psychoses at the University Psychiatric Clinic Würzburg 1971: Inventory u. Comparison with d. Years 1959 - 1965 at d. University Mental Clinic Marburg . Würzburg, Univ., Diss., 1982
  • Nosal, Olivier: Se soigner par le corps, Manifeste en somatothérapie . Chaumont, Éditions Apprendre autrement, 2013
  • Lechler, Walther H; Carex Lair, Jacqueline: Renaitre par Lámuor & Le Moèle de Bad Herrenalb. L'histoire merveilleuse d'une guérison par la somatotherapy . Wiesbaden, Müller, 2003

Individual evidence

  1. ↑ a b c Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . Urban & Schwarzenberg, Munich 3 1984; (a) S. 524 to Lexikon-Stw. "Somatotherapy"; (b) p. 628 on Lexikon-Stw. “Compulsion, external”; (c) see (a) to Lexikon-Stw. "Somatotherapy".
  2. ↑ a b c Asmus Finzen : Why are our patients actually getting well again? Mabuse-Verlag, Frankfurt 2012, ISBN 978-3-86321-023-6 ; (a) p. 74 ff. on head. “Somatotherapy”; (b) p. 57 ff. on tax. “Sociotherapy”.
  3. ↑ Klaus Dörner and Ursula Plog: To err is human or textbook of psychiatry / psychotherapy. Psychiatrie-Verlag Rehburg-Loccum 7 1983, ISBN 3-88414-001-9 ; P. 24 f., 228 on stw. "Force".
  4. ↑ a b c d Klaus Dörner : Citizens and Irre . On the social history and sociology of science in psychiatry. (1969) Fischer Taschenbuch, Bücher des Wissens, Frankfurt / M 1975, ISBN 3-436-02101-6 ; (a) pp. 32, 36 f., 55, 69, 92, 95, 103, 114, 120, 192-199, 234 f., 247 f., 252, 285, 288 f., 316, 331, 335 to Stw. "Zwang"; (b) p. 229 on Stw. "Johann Christian Reil as the first proponent of somatotherapy in Germany"; (c) p. 268 on head. “Critique of traditional medication prescriptions” (d) p. 201 on head. “Wave of founding orthopedic and psychiatric facilities around 1788”.
  5. ↑ Johannes Siegrist : Textbook of Medical Sociology . Urban & Schwarzenberg, Munich 3 1977, ISBN 3-541-06383-1 ; (a) pp. 4, 7, 9, 14, 143 ff. on the section on “Psychiatry”; (b) pp. 27, 35 ff., 42 f., 46, 227 on stw. “negative and positive sanction”.
  6. ^ A b Otfried K. Linde : Pharmacopsychiatry in the course of time . Experiences and results. Tilia, Klingenmünster 1988; Page 1 ff.
  7. ^ A. Mechler: Das Wort ›Psychiatrie‹ , Nervenarzt 34: 405-6, 1963.
  8. ↑ a b Erwin H. Ackerknecht : Brief history of psychiatry . Enke, Stuttgart 3 1985, ISBN 3-432-80043-6 ; (a) p. 62 on Stw. Ernst Horn; (b) p. 101 ff. on stw. “The newer somatic-empirical treatment methods”.