[Psychoanalytic geriatric psychosomatic medicine--on the origin and differential therapeutic indications of acute functional somatization in the elderly].

Acute functional symptomatologies regarding elderly have thus an underestimated meaning as well for be the concerned themselves as for their surroundings and the general public. Based on outpatient or/and inpatient gerontopsychosomatic experiences of treatment with 20 patients at the age from 55 to 75 years (with an average age of 64.5 years), the author differs characteristical constellations of inner and outside reality for the elderly, which can lead to an acute functional symptomatology: 1. the activation of a psychosexual conflict which do not dependent on age 2. the conflict of being disappointed in the elderly 3. the trauma reactivation in the elderly. The differential psychogenese of those three groups is casuistically proofed and discussed from a methatheoretical point of view using the concept of nucleus conflicts (Loch 1967) and the intersection metapher of Heigl-Evers and Heigl (1984). The aim of the work is to demonstrate possibilities of gerontopsychosomatic treatment as well for massive symptomatology and to discuss the given differential indications of psychotherapy (long term analysis, analytic psychotherapy, focus therapy).