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[妇科领域的心身疼痛。心身反应和症状形成的阶段及病例示例(作者译)]

[Psychosomatic pain in the field of gynecology. Stages of the formation of psychosomatic reactions and symptoms with examples of cases (author's transl)].

作者信息

Poettgen H

出版信息

Geburtshilfe Frauenheilkd. 1976 Dec;36(12):1043-53.

PMID:1010294
Abstract
  1. Understanding disease in the context of a hermeneutic of the ill person's life history forces us to abandon the old understanding of causality which is represented by the model of body-soul polarity. The real onset of an illness has a biographic pre-history. Long latent periods may occur before and between "functio laesa" and actual damage to the involved organ. On the basis of psychosomatic case histories, we can conclude that the future-orientation of an individual's life, that for which man must make decisions, is also that which causes the crises situation for those who are suffering. 2. Psychosomatic medicine cannot simply be included in an already existing medical discipline such as, for example, perinatology can be included in gynecology or pediatrics. It implies a whole new understanding of illness and, above all, it requires a new attitude on the part of the physician. The patient must be allowed to cooperate in his self-realization; the physician himself becomes the medicine. 3. An attempt was made to illustrate the concept of "organ language" on the basis of 6 brief examples from psychosomatic gynecology. Here only the most important information was presented. According to the concept of "organ language", the soma and psyche of the suffering person can represent and interpret each other reciprocally. It also becomes obvious that conflicts at various strata of being can use one and the same physical symptom if a common denominator is present (e.g., defence overagainst a danger, a disease or a role). This type of teleological nosology implies a new dimension for the consideration a disease, namely, the question of the meaning of suffering. 4. The examples cited are almost exclusively found in the understanding of sexuality in the broadest sense of the word. The threat of individuation as the final personality organization resulting from inadequate realization of the individual's own sex determination (Friedrichs) is present. 5. The sixth example clearly illustrates that sexuality is not what it is commonly considered to be. Rather, it permeates all state of personality and extends beyond them into areas of cultural and intellectual life. Whether or not a woman engages in sexual activity is not important (as had originally been thought). What is important is her attitude toward her own sex, toware her sexual activity and, therefore, also toward her partner and the environment. True sexual activity means infinitely more than just the automatic physiological act. In total self-abandonment to the "Thou", perfect sexual love becomes a knowing penetration of being. Genesis 4:1 states: "Now Adam knew Eve his wife...". The Hebrew word for "know" (yada') means both to know and to beget. Through the mystery of this word, something of the perfection, of the "participation mystique" in the work of creation becomes transparent in the perfect sexual union of two human beings!
摘要
  1. 从患病者生活史的诠释学角度来理解疾病,迫使我们摒弃由身心两极模式所代表的旧因果观念。疾病的真正发作有着传记式的前期历史。在“功能受损”与所涉器官实际受损之间以及之前,可能会有很长的潜伏期。基于身心医学案例史,我们可以得出结论,个体生活的未来导向,即人必须做出决策的方面,也是给受苦者带来危机状况的原因。2. 身心医学不能简单地被纳入现有的医学学科,例如围产医学可以被纳入妇科学或儿科学。它意味着对疾病有全新的理解,最重要的是,它要求医生有新的态度。必须允许患者参与自我实现;医生自身就成为了药物。3. 我们试图依据身心妇科的6个简短例子来说明“器官语言”的概念。这里仅呈现了最重要的信息。根据“器官语言”的概念,受苦者的身体与心理可以相互呈现和诠释。同样明显的是,如果存在一个共同因素(例如,抵御危险、疾病或角色),存在不同层面的冲突可以利用同一个身体症状。这种目的论疾病分类法意味着对疾病的考量有了一个新维度,即受苦的意义问题。4. 所举例子几乎都出现在对最广义的性的理解中。因个体自身性别认定未充分实现而产生的作为最终人格组织的个体化威胁(弗里德里希斯)是存在的。5. 第六个例子清楚地表明,性并非通常所认为的那样。相反,它渗透到人格的所有状态,并延伸到这些状态之外,进入文化和精神生活领域。一名女性是否进行性活动并不重要(如最初所认为的那样)。重要的是她对自己的性别、对自己的性活动的态度,因此也包括她对伴侣和环境的态度。真正的性活动所意味的远不止是自动的生理行为。在完全向“你”的自我舍弃中,完美的性爱成为对存在的一种认知穿透。《创世纪》4:1说:“亚当认识了他的妻子夏娃……”。希伯来语中表示“认识”的词(yada')既表示认识也表示生育。通过这个词的奥秘,在两个人的完美性结合中,创造工作中的某种完美、“神秘参与”变得明晰起来!

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