[Stress or trigger situation. 2 notions illustrated by a comparison of stress ulcer to triggering of attacks of gastroduodenal ulcer disease].

The author attempts to show the fundamental difference existing between the two often confused concepts of "stress" and "trigger-situation", using the example of "stress ulcer" and "trigger-situation" of the outbursts of the ulcer disease. The stress ulcer or acute ulcer is compared to a door forcefully kicked in. It is unspecific like the adaptation syndrome of Selye. The trigger-situation as we understand it is a current conflict situation, i.e. a well-defined and specific event that is only conflictual for a very specific personality structure (one of the four psychosomatic types according to M'Uzan). In contrast to the picture of the door forcefully kicked in as in the stress ulcer, for the trigger-situation of the outbursts of the ulcer disease, we have used a picture of Beck: a key perfectly fitting the lock. All case records show that while an event can become the trigger-situation for one of the four psychosomatic types according to M'Uzan, it will not be for a different type. The specificity resides in the fact that this trigger-situation is a current conflict situation. The present conflict corresponds to a transfer of the infantile intra-psychic conflict to the present situation. When this current conflict reaches a sufficient intensity, the defence system built up by the patient is thereby decompensated--through frustration either of the neurotic activity or passivity desire of the patient and the conflict triggers the symptom, the ulcer attack.