COODLEY A
Calif Med. 1952 Dec;77(6):401-5.
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.
由于新的研究方法和途径，心身医学领域最近有了进一步的认识。根据塞利的一般适应综合征概念，包括警戒、抵抗和衰竭阶段，高血压、溃疡性结肠炎、类风湿性关节炎、消化性溃疡、糖尿病和心血管功能障碍等疾病可能代表了身体适应慢性应激的方式。据推测，患者未意识到的无意识动力在理解和解释心身疾病患者的生理研究及治疗中至关重要。部分退行的概念适用于在社会、经济和职业领域非常成功的心身疾病患者。这种疾病被视为通过有限的躯体退行来防止心理退行。初步研究表明，患有溃疡性结肠炎和哮喘等严重疾病的患者，在医院环境中，由一位“全心付出”的医生通过过度溺爱、娇惯和呵护来强制进行心理退行并利用其依赖性，会有良好反应。良好的医患关系仍然是治疗的基石，也是许多所谓成功治疗模式的共同要素。
