Zander W
Z Psychosom Med Psychoanal. 1982;28(2):126-38.
Based upon Selye's Model of Stress and its expansion towards so-called "internal Stress' the possibility of actual stress diseases is discussed first. In contrast to this, however, those who form the majority of patients in the psychoanalysts' practice. They do not become ill "from simple" psychosocial stressors but rather in connection with conflicts of ambivalence--the so-called situations of temptation and self-denial--which, due to neuroticizing mechanisms in early childhood, they are unable to master, since they remain unaware of at least one of the antagonistic tendencies. Based upon conceptions of a simultaneous correlation of psyche and soma, these respective correlating antagonistic functions must take place while experiencing the ambivalence conflicts, which are termed "strain" in distinct opposition to stress. In the course of specific investigations of the correlation in patients with ulcus duodeni, asthma bronchiale, colitis ulcerosa, and Morbus Crohn, several functional elements of strain could be demonstrated which can easily be incorporated into a pathophysiological context as constituting elements of later morphological changes. A psychosomatic illness of this kind predominantly obeys the autonomy of the body.