Knüsel H
Psychiatrie/Psychotherapie FMH, Luzern.
Praxis (Bern 1994). 2006 Apr 5;95(14):533-9. doi: 10.1024/0369-8394.95.14.533.
The dependence of the patient-doctor-relationship on social change is briefly pointed out. The special challenge for the therapeutic relationship patients with somatoform disorders give rise to, is thoroughly outlined. The fact that patients with somatization are prone to use unconventional therapies is the reason for an analysis of the placebo effect. This analytical consideration allows to demonstrate that the success of the unconventional medicine relies on characteristic healing factors usually hidden in the blackbox placebo. Acqainted with such healing factors the science oriented physician may recognize new possibilities to improve his therapeutic impact with a kind of supplementary placebo effect. Eventually a practical procedure based on modern psychology is proposed to deal with patients with somatoform disorders.
简要指出了医患关系对社会变革的依赖性。全面概述了躯体形式障碍患者给治疗关系带来的特殊挑战。躯体化患者倾向于使用非传统疗法这一事实，是分析安慰剂效应的原因。这种分析性思考表明，非传统医学的成功依赖于通常隐藏在安慰剂“黑箱”中的特征性治疗因素。熟悉这些治疗因素后，以科学为导向的医生可能会认识到利用一种补充性安慰剂效应来提高其治疗效果的新可能性。最后提出了一种基于现代心理学的实际方法来应对躯体形式障碍患者。
