From the author: In psychosomatics, it is customary to highlight individual psychological characteristics that are characteristic of different patients. Today we will continue the conversation about what character traits and life circumstances can lead to diseases such as stomach and duodenal ulcers, neurodermatitis and psoriasis. It is more important to know what kind of person is sick than to know what a person is sick with. Hippocrates Gastrointestinal Diseases tract The main functions of the gastrointestinal tract - absorption and excretion - are closely related to the emotional state of a person, to his relationships with other people and to the external living space. Motor, vegetative, humoral and central processes in this somatic sphere cannot be isolated from the mental state of a person. This internal connection leads to the fact that the emotional state of a person when eating food influences the further process of its digestion. Experiences such as aggression, apprehension, fear, depression inhibit the functions of the stomach and intestines, disrupt motility and, as a result, lead first to functional and then to organic changes in the structure of the gastrointestinal tract. Aggression, apprehension and fear are biologically experiences are associated with the function of muscle cell contraction. When there is danger or aggression, a reflex spasm and tension occurs. As a result, food enters the esophagus, stomach, and intestines, which are spasmed and clamped from stress. The consequence of this is a wide range of gastrointestinal disorders, ranging from gastritis to perforated ulcers. Stomach and duodenal ulcers. From a medical point of view, a stomach ulcer refers to an imbalance between factors that protect the mucous membrane and aggressive factors, which leads to a kind of self-digestion of the stomach wall. The connection between emotions and stomach function has been clearly proven by scientists back in 1956 And in 1981, using X-rays, it was shown that the stomach reacts spastically even when mentioning situations associated with the experience of negative emotions. From a psychoanalytic point of view (according to Alexander), ulcerative symptoms are a reaction to obstacles to oral-receptive aspirations. That is, a person who regularly does not receive satisfaction of his needs and does not know how to experience pleasure from life (literally “does not digest” it) risks ruining his health. Psychological portrait. In a large number of patients suffering from stomach diseases, the desire for professional success and money is replaced by concerns about spiritual food. The sphere of contacts is often underdeveloped. An exacerbation of the disease occurs with separation and loss of security. In the parental home of patients with stomach ulcers, achievements and frugality played an important role. Feelings such as bitterness and anger were not expressed openly, but were, as it were, “swallowed” and “eaten up,” which continued into adult life (from patients with duodenal ulcers you can hear expressions about the manifestation of anger, the desire for revenge and retribution). A feature of such people Great ambitions and desire to achieve high results in all areas of life become. Disbelief that this is practically impossible (and often not at all necessary) is combined with high self-criticism and demands on oneself. The other side of personality, expressed in imagination and fantasies about a better life, reveals to us a person who dreams of care and love, who wants to be understood and protected. The typology of ulcer patients offers the following division (Overbeck, Biebl, 1975): 1. Mentally “healthy” ulcer patient. Individuals with good ego function and stable relationships are prone to illness in the event of strong emotional stress.2. An ulcer patient with character neurosis. As a rule, a managerial employee prone to causing aggression in others. Illness may arise due to special experiences of resentment, failure or loss of love.3. Sociopathic ulcer patient.Passively dependent patients with a weak self, excessive dependence on other people, prone to antisocial behavior (alcoholics or rental neurotics). They get sick even with minor external refusals of love and attention to themselves.4. “Psychosomatic” ulcer patient. Inexpressive personalities with poor imagination and superficial relationships. Often, along with peptic ulcer, other psychosomatic disorders are observed, such as fever, cardiac symptoms, rheumatism, etc. In addition, an increase in accidents and surgical interventions is noted in such patients.5. “Normopathic” ulcer patient, overly adaptive and oriented towards normal behavior. He brings himself to the point of complete exhaustion with work and additional responsibilities, and is constantly under the influence of stress overload, which ultimately leads to acute illness. Eating and digestive disorders. Psychosomatic medicine understands the language of organs as an expression of emotional phenomena and distinguishes them from constitutional factors and hereditary predisposition. Bodily phenomena related to eating behavior and digestion are correlated with certain emotional processes (according to Staehelin, 1963):• difficulties in mastering (stomatitis, symptoms of the oral mucosa);• inability to swallow something (eating disorders, swallowing);• being rejected, despised (loss of appetite, heartburn, vomiting, weight loss);• unsuccessful chronic efforts to digest or assimilate something (stomach pain, excessive peristalsis, pylorospasm, ulcer);• chronic inability to process anything (pain, enterocolitis, irritability of the large intestine );• inability to give something away (chronic constipation);• desire to throw something away (chronic diarrhea). Skin diseases Along with physiological functions (heat exchange, touch, protection, etc.), the skin also has psychological significance. The skin is an organ of contact with other people: gentle touch and pain, sexual arousal, and abuse are primarily experienced by the human skin. Based on the condition of the skin, one can imagine the internal state of another person. Therefore, the skin is called a mirror of mental processes. In terms of psychosomatic connections in skin diseases, the central place is occupied by diseases, the origin of which involves, on the one hand, predisposition factors, and on the other, mental difficulties and conflicts that cause their occurrence. In 1891, French dermatologists L. Broc and L. Jacquet established a connection between chronic eczema and mental processing and therefore gave this disease the name “neurodermatitis”. Neurodermatitis is still the focus of attention in the psychosomatics of skin diseases. Neurodermatitis (atopic dermatitis, diffuse neurodermatitis, endogenous eczema, constitutional eczema). We are talking about a widespread skin disease with a chronic course, in which itching, infiltration, thickening and eczematous changes in the skin are noted. The disease often develops in combination with other allergic diseases, primarily with vasomotor rhinitis, urticaria and bronchial asthma. Attacks of neurodermatitis often occur with problems in partnerships, separation or the appearance of persons who have great emotional appeal for patients. Often, experiences and manifestations of strong affects, expectations, desires for intimacy, sexuality and its frustration are revealed due to one’s own ambivalence or the partner’s refusal. With these conflicts associated with the situation of rapprochement, many descriptions emphasize the role of one’s own corporeality, desire and satisfaction, the ability to show and present oneself in bodily form. These descriptions are usually defined by the concept of “exhibitionism.” If you analyze the life history of a patient with a skin disease, you can identify early deficits in the area of ​​the body and sensations. In this, the patient with skin diseases develops special, well-differentiated, although apparently contradictory abilities. He can be called thick-skinned at the same time,and thin-skinned. On the one hand, he shows indifference and distances himself in relationships, afraid of getting a “mental wound”; on the other hand, he needs intimacy and seeks close contact. Due to a lack of openness and a tendency to please while suppressing aggression, disagreement and frustration quickly arise. If someone cannot stand up for themselves, “throw someone a punch,” then symbolically the skin takes on this task in the form of “rashes.” And then you can give yourself the will to scratch, scratch and, thus, reduce the level of psychological stress (according to N. Pezeshkian). Psychological portrait. Although one should not expect a uniform character structure in patients with neurodermatitis, typologically defined similarities can still be found. There is a direct connection between the severity of the pseudo-allergic reaction and the severity of the conflict or traumatic situation, as well as the degree of emotional disturbances (emotional tension, anxiety, depression and fear, which sometimes takes on the character of phobias). Transferring to another job or moving to a new apartment, illness and death of loved ones or divorce, fear of an exam or fear of an unwanted pregnancy form the basis of such symptoms, which develop for the first time or, more often, recur after a more or less long (sometimes many years) remission. People with a skin disease are often characterized by pronounced passivity. They find it difficult to assert themselves. The onset of the disease is often accompanied by conflicting partnerships. At the same time, according to the area of ​​distribution of eczema, two groups of patients should be distinguished: • with only externally formal dyadic (paired) relationships, eczema spreads in the area of ​​​​the joints, face and head; • with visibly tense dyadic relationships, spread in the chest, hips and shoulders is observed. Aggravates the situation is the aesthetic side of the issue. The possibility of a disapproving reaction from others to the external manifestations of the disease causes in patients an exaggerated sense of physical and social inferiority, and heightened susceptibility to these reactions aggravates emotional tension, suspicion and wariness, which pushes the suffering person onto the path of negativism and social isolation. Psoriasis. The development of psoriasis is associated with severe mental shocks and misfortunes - in 40% of cases and with the experience of expressed negative emotions - in 52% of cases (according to V.D. Topolyansky and M.V. Strukovskaya). This is one of the few diseases directly related to the mental factor. The current medical opinion about the incurability of this disease is associated with ignoring the psychological factor of the disease, which is the trigger for the onset of the pathogenic process. For the same reason, treatment with psychotropic drugs often brings an improvement in the patient’s condition, since it is often discovered that psoriatic elements simply mask a neurotic or psychotic disorder (you can read about “masked depression” in the article “Depression... There is a way out!”). Psychological portrait. An increase in the disorder is observed against the background of mentally aggravating situations, such as traumatic events and a threat to the safety, life and health of patients. Skin patients are characterized by unstable self-esteem. They exhibit symptoms such as fear, depression on the one hand and pronounced behavioral reactions on the other. Patients with psoriasis are also prone to demonstrativeness. Such people are characterized by high sensitivity, both literally and figuratively. They literally react with their skin to any changes in their lives: even simple everyday troubles and overwork can cause an exacerbation of the disease in them. In this regard, a good prevention of deterioration in health as a result of unplanned stress (which is already the norm in the modern world) can only be serious work on oneself, on one’s attitudes and life positions. Psychological assistance for diseases Despite the fact that with these diseases certain psychological. 11-13.