Delahousse J, Hitter-Spinelli B, Pedinielli J L
Schweiz Arch Neurol Neurochir Psychiatr. 1982;131(1):41-54.
Hypochondriac patients defy medical practice, misuse medical language and discourage medical classifications. Their peculiar use of medical knowledge impoverishes the relational dimension, obscures the personal history as if the patient wanted to hold, to control and to maintain some obscure object within his body. When this hypochondriac defence is not powerful enough, the psychiatric condition becomes much worse. There must be some serious necessity to substitute to the obscure object of desire, the object of a universal knowledge; this necessity may happen in selective conditions. The psychodynamic study of such cases leads to the following hypothesis: decompensation occurs when the patient is no longer able to maintain simultaneously two antinomic positions toward the other: to keep his place and to keep the object of his desire. Consequently, he tends to materialize this object, in which he believes, wanting simultaneously to keep it inside and to reject it outside. Of course, this fundamental misunderstanding about desire leads the patient to ask impossible questions to medicine: naming the object (no longer of desire but indeed of faith) and expelling it (so asks he, but he does not really want). This constitutes, of course, a religious use of medicine: it is impossible for our knowledge to have a universal meaning and to respond exhaustively about each peculiar history.
疑病症患者违背医疗常规，滥用医学术语，阻碍医学分类。他们对医学知识的独特运用削弱了人际关系层面，模糊了个人病史，仿佛患者想要在体内持有、控制并维系某个模糊的客体。当这种疑病症防御不够强大时，精神状况会变得更糟。必然存在某种严重的必要性，用普遍知识的客体替代欲望的模糊客体；这种必要性可能在特定条件下出现。对此类病例的心理动力学研究得出如下假设：当患者不再能够同时对他人维持两种相互矛盾的立场时，即保持自己的位置并保留欲望客体时，就会出现代偿失调。因此，他倾向于将自己所相信的这个客体具象化，同时既想将其留在体内又想将其排出体外。当然，这种对欲望的根本误解导致患者向医学提出不可能的问题：命名客体（不再是欲望的客体而是信仰的客体）并将其排出（他如此要求，但并非真的想这样做）。当然，这构成了对医学的宗教式运用：我们的知识不可能具有普遍意义并详尽回应每一段独特的经历。
