A Therapy of Eating Disorders from the Viewpoint of Body Therapy : Is Psychological Self-insight Necessary to a Therapy of Psychosomatic Disorders?

Takao Tatsuo

doi:10.15064/jjpm.39.8_603

In the treatment of psychosomatic disorders, even when treatment is based on the same theory, it is a well-known fact that the relationship between patient and doctor has a great effect on recovery. Therefore, in the treatment of psychosomatic disorders, an investigation was made on eating disorder to better understand the effectiveness of the pediatrician, who is good at physical treatment, in responding to patients based on the relationship between patient and doctor. The subjects were 25 outpatients who were treated at our hospital between June 1994 and December 1996. Outpatients treatment focused on physical examination and physical phenomena. A psychological principle was maintained by which the presentation of the problem was awaited from child patients with reference to Kurokawa's "outpatient treatment in view of a strong feeling against hospitalization". As a result, there were many cases in which satisfactory recovery was seen without fully obtaining the psychological insight. Conversely, there were cases in which psychological problems appeared to be the main problems after physical stability was achieved, which complicated the response to patients. In those cases, by sympathetically examining the physical conditions, which the patients felt closest to themselves, a rapport was maintained so that child patients could discuss problems of the mind from their perspective. There were cases in which children used their self-recovering power to overcome problems of the mind without being noticed by the doctor. In cases where the onset of the disorder was caused by school or studies, the main reason for recovery was due to a strong psychogenic reaction factor. Through strong family support to the child patients, coupled with the full assurance for physical support, their self-recovering power must have been enhanced. Conversely, when the cause was family related, family support to child patients was generally weak, which prevented full recovery through physical support. For outpatients suffering from minor psychosomatic symptoms, the cause was mainly related to school. By properly explaining to parents the fundamental correlation between mind and body (as well as child development) using a sympathetic analysis of both body and mind, no special psychological treatment may be necessary to respond to wide range of patients, as was seen in this report. For the pediatrician who requested another doctor to conduct psychological treatment, this method seems useful. Therefore, the repletion of psychosomatic education in madical faculties is greatly anticipated.

A Therapy of Eating Disorders from the Viewpoint of Body Therapy : Is Psychological Self-insight Necessary to a Therapy of Psychosomatic Disorders?

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