Chase Patterson Kimball

Conceptual Developments in Psychosomatic Medicine: 1939-1969

Abstract The term psychosomatic medicine has undergone theoretical shifts during the last 30 years. After Cannons initial observations of specific physiological changes accompanying specific emoti...

The Experience of Open Heart Surgery

In this report we focus on 11 items used by nurses in rating behavior in the three-week period following cardiac surgery and correlate these with data collected pre-operatively in terms of adaptation,

Psychological Dependency on Steroids

Abstract Clinical experience suggests that many individuals treated with corticoids become psychologically dependent on their euphoric side effects. This dependency, which may result from a number ...

Induction of ovulation and pregnancy in patients with anorexia nervosa

Abstract Ovulation induction with HMG-HCG in three patients with anorexia nervosa is reported. Despite the nutritional and psychiatric problems associated with this disease, these patients tolerated the emotional and physical challenges of fertility failures, pregnancy, delivery, lactation, and early motherhood extremely well. Unexpectedly, two patients reverted to spontaneous ovulatory menstrual cycles following delivery. Usually hypogonadotropic hypogonadal women require retreatment with HMG-HCG. This reversal was accompanied by return of normal weight and eating habits.

A case of pseudocyesis caused by “roots”

The practice of witchcraft and the idea of curses and hexes are not as foreign to modern medicine and the University Hospital as our sophisticated conceptualizations of illness and therapy lead us to believe. The following case report and discussion dramatizes the presence of such belief systems in the very midst of our urban practices as much as the film “Rosemary’s Baby” suggests that there is the potential for a mystical belief system in many usually rational individuals. Here, we report on a case of a patient with a false pregnancy attributed to “roots.” In our brief contact with this patient, it appeared that the physicians knowledge of this possibility was essential both to the diagnosis and management of the patient’s discomfort.

Liaison psychiatry in the university medical center.

ceptual approaches unique to psychology and psychiatry into the arena of general medical care and research. It is the purpose of this paper to examine in greater detail how the above objectives have been accomplished in the past, how they may be extended, and to elaborate some of the difficulties encountered in such an activity. With several notable exceptions, the history and development of psychiatry has been to isolate, if not alienate, itself from the mainstream of medical practice. Indeed, approaches to behavioral disorders have always been and still are frequently relegated to a position somewhere between religion and medicine. The explanation for this lies within the anxieties that bizarre and inexplicable behavior causes in all of us. We, in turn, are utilizing our own defenses to keep our own potential for similar behavior at bay. Without an understanding of perverse behavior, man has called upon his less rational processes to ascribe such behavior to unknown demonic forces beyond his comprehen/sion and control. The various traditions that have developed to understand behavior have for the most part developed within a scientific framework after the traditions in the rest of medicine. However, the hypotheses of the new psychologic disciplines have acquired a force of their own that has taken them far afield from their medical descent. Nowhere is this more apparent than in the tradition of psychoanalysis, a discipline that had its beginning as a firmly based biologic science. Whether or not explanations for abnormal behavior have derived from a scientific foundation or a more mi~taphysical one, the net results in almost all instances have been to separate psychiatry from the rest of scientific medicine. This is equally the case whether the school of psychiatry characterizes itself as basically organic, social, behavioral, or psychoanalytic.

Medicine and Dialects

Excerpt The Physician speaks a strange and often unintelligible dialect. He calls everyday common objects by absurd and antiquated terms. He speaks of mitral commissurotomies, pituitary insufficien...

Role of liaison psychiatrist in teaching medical students

Abstract I have attempted to outline the approaches of the Psychiatric Consultation-Liaison Service at Yale to the Undergraduate Curriculum. Several basic principles have been scored, i.e., emphasis on how data is obtained and objectified via the interview method, how the data is formulated according to a number of conceptual schemes, and how all aspects of the patients life has relevance to the physicians understanding of symptoms. Emphasis is given to the model of the teacher as an integral part of the process. The form via which the process occurs and some aspects of the content which is transmitted through the process and the form are identified. These require evolving research and clinical programs on the part of staff in order to remain stimulating and rewarding to ourselves and our student.

Techniques of Interviewing: Setting up an Interviewing Course

In this article the logistics utilized in conveying a specific type of interviewing technique to students, previously reported on, are outlined. Specifically described is an introductory course that has been effective in communicating interview techniques to groups of students working closely with a perceptor by alternating demonstration and didactic instruction with trial and error exercises. Since psychiatrists are increasingly used in teaching and directing interviewing courses in medical schools, it is suggested that they be intimately involved in planning these programs.

Interviewing, Diagnosis and Therapy

A good interview is much more than an account of a complaint and a perfunctory review of systems. It involves listening “between the lines” and using the other senses and embodies many psychotherapeutic maneuvers. The physician who lacks skill in the technic of interviewing cannot hope to establish satisfactory doctor-patient relationships, and his diagnostic and therapeutic efforts will suffer.