Microanalysis of the first interview with psychosomatic patients.

Microanalysis of the first interview is a technique developed by the author for the subtle translation of the verbal aspects of the doctor-patient contact. Every bit of information, derived from the patient, is translated in the traditional historical dimension, e.g., when did the complaint start, and in the here and now dimension, e.g., in how far does the information imply a cry for help and understanding. Psychosomatic patients, who are usually well adapted, suppress or repress their problems and emotions so much that they are hardly able to express these quite openly. Psychosomatic symptoms reflect the effort of the patient not to behave in a hysterical way. This means that the overt cry for help and attention, which is so characteristic for hysterical patients, is warded off. Especially the microanalytic translation of this hidden cry may be used by the interviewer to detect what the basic problems of the patient are and how the optimal climate for an efficient therapeutic contact can be established. In the Leyden Department of Psychiatry the technique is used to facilitate the training in interview technique. In the paper models will be given for the understanding of the interrelationship of psychiatric and psychosomatic symptoms.