Psychologic Factors in the Etiology and Treatment of Chronic Headache

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Abstract
In 100 pa-tients with chronic headache, headache was very often found in patients who had suppressed (or were unconscious of) strong feelings of resentment or anger. A var. of other mechanisms were, of course, observed: Hysterical identification or conversion through symbolic displacement, satisfaction of a need for punishment, hypochondriasis of psychotic type, high degree of secondary gain, etc. The great importance in psychotherapy of the physician-patient relationship was emphasized. Even in those patients to whom formal psychotherapy is not given, the therapeutic results often depend in large measure on the psychologic effect of the treatment situation on the patient and especially on the emotional relationship between patient and physician. Wherever possible, ventilation of wholly or partly unconscious emotional conflicts is, of course, therapeutically valuable, as is suitable environmental manipulation.
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