Abstract
Acute and severe somatic illnesses inflict severe psychological stress for the patient. The disturbance of bodily well-being has a serious impact on the narcissistic investment in the body. Thus a vital dimension of self-coherence is called into question. Being confronted with the diagnosis of a chronic illness implies that future life perspectives have become insecure, since the patient must live with the danger of possible relapse. He or she faces unusual dependencies on medical professionals and medical treatment. Therefore confrontation with an acute or chronic disease constitutes a challenge to the personality and its adaptive resources. From the psychoanalytic perspective, there is a special challenge to the defensive repertoire. The aim of defense, as Hoffmann (1987) has pointed out, is to regulate the individual narcissistic balance that is endangered by disease. It is therefore important to study the relationship of defense to the course of and adaptation to a disease. The relevant research issues that have increasingly become influential in present day psychosomatic research as a whole and in our Heidelberg research project on Crohn’s disease can be summarized as follows:
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1.
What is the impact of the preexisting chronic course of a disease on the defense organization during an acute illness?
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2.
What are the adaptive values of the various defense mechanisms in the different phases of the disease?
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3.
What is the impact of the personality on the defense organization during the several phases of the disease?
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Küchenhoff, J. (1993). Defense Mechanisms and Defense Organizations: Their Role in the Adaptation to the Acute Stage of Crohn’s Disease. In: Hentschel, U., Smith, G.J.W., Ehlers, W., Draguns, J.G. (eds) The Concept of Defense Mechanisms in Contemporary Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8303-1_28
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DOI: https://doi.org/10.1007/978-1-4613-8303-1_28
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