心身医学的にみた思春期喘息患者の問題点と解決法(気管支喘息と心身医学)(第32回日本心身医学会総会)
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概要
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These are many factors that make it difficult to treat the patients with bronchial asthma in adolescence. From the psychosomatic point of view, we paint out some problems from which they are suffering and propose the treatment considering the aspect of their psychological development as well as that of somatic care. We interviewed in detail 22 intractable asthmatic patients in adolescence and found the characteristics of psychosocial backgrounds as follows. 1) Many of them rarely received affectionate breeding, especially maternal care in infancy and/or childhood, so that they tend to lack emotional stability and to keep poor relationship to other persons. 2) When in adolescence, they get strong negative feelings such as anger or resentment toward their parents. However, they not only repress their emotion in stead of expressing it frankly but also behave in overadapted manner. This may be due to the fact that many fathers are almost unconcerned about their family, and so mothers consequently feel themselves standing alone, and have to play a role of father as well. Interview with the patients suggests that parents react unpleasantly during athmatic attacks and dominantly during non-attack ; they reject their asthmatic children when the patients really need gentle care (i.e. dependency), and behave dominantly when the children need to act freely (i.e. independency). These parental contradictory attitudes induce the result that asthmatic patients get the negative feelings toward parents, but they suppress these emotions because they believe their mother have received a great deal of trouble, and because they must be taken care of during attack. Therefore, conflict between dependence and independence are unsolved in their inside, which makes patients emotionally unstable when confronted difficult problems, and then go into malajusted state in their social environment. We suppose that this state of malajustment may, in turn, run them into frequent episodes of asthmatic attack. On the basis of those psychosomatic consideration, we must practice not only appropriate drug therapy and prompt care for attack, but also family therapy or psychotherapy for their inner conflicts in the treatment of adolescent asthma.
- 1992-03-01
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