Is there a reciprocal relationship between symptoms and affect in asthma?

This is a hypothesis-seeking case study. It is the product of naturalistic research on one asthmatic patient seen 212 times in individual psychotherapy over a period of 32 months. Both retrospective and prospective data were gathered, the prospective phase beginning about halfway into the therapy. Clinical vignettes are cited from which the following hypothesis was developed: there was a reciprocal relationship between the manifestation of physical symptoms and of affective reactions in this patient. In support of the possibility of testing this hypothesis, the therapist's observations and patient's report of physical and affective reactions each independently indicated a much greater incidence of one reaction or the other occurring separately than of both together. The occasional occurrence of both together indicates that the physical and the affective reactions are not mutually exclusive; therefore, the null hypothesis is also possible. A critique and synthesis of diverse literature ranging from psychoanalytic, group, and behavioral oriented clinical reports to human and animal physiological studies precede the presentation of the case study. The conclusion reached in reviewing the literature is that confirmation of the reciprocal hypothesis awaits further studies, but there is indication in the literature of support for such further study.