[Psychosomatics in gastroenterology]

With regard to the superimposed concept "psycho-somatic correlation" we describe the psychopathological mark "Alexithymia" and the related psychodynamic processes (object loss which cannot be mastered, together with following narcissistic insult and aggression defense). In the frame of the psychosomatic pathology are outlined the psychodynamic processes in patients suffering from functional gastrointestinal disorders, duodenal ulcer and ulcerative colitis. With regard to the superimposed concept "soma-to-psychic correlation" we describe the secondary-psychic reactions following the patient's perception of a failure of his bodily functions, namely: reactive anxieties and depression as well as dependency wishes and denial-work. The psychotherapeutic possibilities in psychosomatic patients concern the modifications of the classical psychoanalytic techniques, namely: psychoanalytically orientated group therapy, psychotherapeutic consultation, supportive psychotherapy on the one hand and the behavior therapy on the other hand. In contrast to it, in patients suffering from secondary-psychic reactions particularly the principle of the doctor's and nurses' emotional presence is indicated. However, the ability to realize the emotional presence function presupposes a special advanced training.