Knowing the unspeakable: Affectivity, object relatedness and the processes of somatization in individuals suffering with chronic somatic distress.
Item
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Title
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Knowing the unspeakable: Affectivity, object relatedness and the processes of somatization in individuals suffering with chronic somatic distress.
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Identifier
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AAI3008810
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identifier
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3008810
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Creator
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Blaustein, Jeanne Patz.
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Contributor
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Adviser: Steven B. Tuber
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Date
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2001
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical | Psychology, Developmental | Health Sciences, Mental Health
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Abstract
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This study explores the fluctuating capacities for affectivity and object relatedness in three individuals suffering with unexplained chronic distress. This study contributes to the field of psychosomatic medicine and to psychoanalytic theory of somatization by linking the processes of somatization with recent work in the areas of affect regulation and the internalization processes of object representation.;A time-series analysis with a multiple case-study design was chosen in order to examine the unpredictability of remissions and eruptions of chronic unexplained somatic distress in the context of a design into which time and change were meaningfully incorporated.;The principal instruments used in the study include the Epigenetic Assessment Rating Scale (EARS) (Wilson et al., 1988), a psychoanalytic rating scale designed to score narrative material; the Recent Experience Memory Test (Blaustein, 1994), a variation of Mayman's Early Memory Test designed to be administered weekly; the Symptom Checklist 90-Revised (Derogatis, 1977); and the Illness Narratives Interview-II (Blaustein, 1994), a semi-structured questionnaire designed to elicit ratings and descriptions of illness experiences.;Shifts in object relatedness were more strongly associated with shifts in somatic symptomatology than were shifts in affectivity. These differences were significant in most cases. Higher levels of empathic understanding and mutuality were generally associated with lower weekly levels of somatic distress. Complex relationships between shifts in object relatedness and the onset of somatic symptoms were identified. Significant differences among subjects were found.;These findings strongly point to the possible importance of disturbed early interpersonal experiences in the etiology of the processes of somatization. The existence of various temporal relationships between factors is of clinical interest as it may begin to shed light on the often unpredictable patterns of somatic distress reported by so many patients. These findings point to the need for psychoanalytically-oriented psychotherapy with somatizing individuals in order to rework and rebuild problematic self- and object representations resulting from experiences of early and profound empathic failures.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
