How Are ‘Psychosomatic’ Patients Different from ‘Psychoneurotic’ Patients?

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Abstract
White male patients (2 groups) were selected on the basis of their acceptance or rejection by psychiatric residents for extended treatment. The group of patients eagerly accepted were mostly college students with anxiety, several of a phobic type, while the completely rejected group was composed of rheumatoid arthritic patients. Examination of samples of verbal transcript material showed that previously determined criteria, established on the basis of content analysis of interview transcripts, placed the arthritic patients very much in the unsuitable for psychotherapy category, whereas the selected patients were highly suitable. Verbal patterns in several different contexts were compared to show the differences concretely; another such comparison also showed the abundance of psychosomatic diseases in the families of the arthritic patients. Comparison of verbal material showed that patients with anxiety tended to be acutely sensitive to the future and to human relations, especially those with physicians in a personal sense. Arthritic patients worried much less, attended little to the future and incongruously reported that they were in command of feelings. In a hospital psychiatric ward, anxious patients soon adapted with relief; the arthritic in such a ward insisted that he follow his own idea of the behavior of the hospitalized patient, complete with night clothes and bed rest. The 2 types of patients should live in quite separate universes of discourse.

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