The experience of myocardial infarction as a threat to one's personal adequacy.

This report of a clinical case conference on a 40-year old man with acute myocardial infarction is presented in a format that readers of this journal may find useful in their teaching of health professionals and students. The report illustrates some psychologic aspects of myocardial infarction and the impact it had on this particular patient. In this case, the myocardial infarction reactivated some underlying unresolved conflicts about personal adequacy that the patient had previously kept under check by some fragile defense mechanisms. Thus, it disrupted the personality organization and produced emotional upheaval and maladaptive behavior. This in turn was deleterious to the patient's physical health. This case, therefore, illustrates the importance of the biopsychosocial approach in the understanding and treatment of medical illness.