Summary
The relevant psychologic facts bearing on treatment of ulcerative colitis patients are:
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1.
The colitic process begins or recurs in a setting in which the patient feels, consciously or unconsciously, that he has suffered or will suffer the loss of an important object relationship.
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2.
He responds to this with a feeling of helplessness, hopelessness, despair, a feeling that this is “too much,” and that he cannot go on.
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3.
By virtue of a lifelong mutually dependent relationship with certain key figures, especially the mother, he has not achieved the capacity for independent function that characterizes the more mature person.
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4.
He looks to the physician to take over in the areas in which he feels incompetent and not to let him down.
The treatment of the ulcerative colitis patient has been discussed in terms of these psychologic principles.
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References
Engel, G. L. Studies of ulcerative colitis: I. Clinical data bearing on the nature of the somatic process.Psychosom. ed. 16:496, 1954.
Engel, G. L. Studies of ulcerative colitis: II. The nature of the somatic processes and the adequacy of psychosomatic hypotheses.Am. J. Med. 16:416, 1954.
Engel, G. L. Studies of ulcerative colitis: III. The nature of the psychological processes.Am. J. Med. 19:231, 1955.
Engel, G. L. Studies of ulcerative colitis: IV. The significance of headaches.Psychosom. Med. 18:334, 1956.
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Supported in part by a grant from the Foundations Fund for Research in Psychiatry.
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Engel, G.L. Studies of ulcerative colitis. Digest Dis Sci 3, 315–337 (1958). https://doi.org/10.1007/BF02232412
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DOI: https://doi.org/10.1007/BF02232412