New vistas in psychosomatic medicine.

Further understanding in the field of psychosomatic medicine has come to light recently as the result of new approaches and methods of research. Such diseases as hypertension, ulcerative colitis, rheumatoid arthritis, peptic ulcer, diabetes and cardiovascular dysfunction may represent the body's method of adapting to chronic stress, according to Selye's concept of the general adaptation syndrome, with the phases of alarm, resistance and exhaustion. It has been postulated that unconscious dynamics of which patients are unaware are crucial in the understanding and interpretation of physiological research and therapy of patients with psychosomatic disorders. The concept of partial regression was applicable to patients with psychosomatic illness who were highly successful in social, economic and professional spheres. The illness was viewed as a protection against psychological regression by limited somatic regression. Pilot studies suggested that patients seriously ill with such disorders as ulcerative colitis and asthma responded favorably to enforced psychological regression and exploitation of dependency by excessive coddling, babying and mothering by an "all-giving" physician in a hospital setting. Good physician-patient relationship remains the keystone in therapy and is the common denominator to many so-called successful modes of treatment.