[Psychosomatic personality structure--fact or fiction?]

This article describes the different approaches to explaining psychosomatic disease according to the gradual scientific development of this concept in the course of medical history. Whereas Freud and also some of the later psychoanalytical authors considered psychosomatic disease as a special form of neurosis, recent efforts are directed at working out a specific psychosomatic personality structure which can be differentiated against that of the neurotic or psychotic personality. Besides the concept of the "infantile personality" formulated as early as 1948 by Ruesch in respect of the psychosomatic patient, specific characteristics of a psychosomatic personality have been outlined during the sixties by a French working team as part of a concept which they called "operative thinking"; independent of this development, American authors have also defined such specific characteristics under the designation "alexithymia". The central aspect of these definitions concerns a disturbance of affective perception and of the ability to psychic or affective working-over. The critical discussion of these approaches is carried out both on a theoretical and on a methodical empirical level. Basing on an empirical study conducted by the author himself, methodical drawbacks of previous studies are discovered and pointed out.