Book contents
- Frontmatter
- Contents
- Foreword
- Acknowledgments
- Acknowledgment of permission for use of material
- Introduction
- 1 The development and regulation of affects
- 2 Affect dysregulation and alexithymia
- 3 Measurement and validation of the alexithymia construct
- 4 Relations between alexithymia, personality, and affects
- 5 The neurobiology of emotion, affect regulation, and alexithymia
- 6 Somatoform disorders
- 7 Anxiety and depressive disorders and a note on personality disorders
- 8 Substance use disorders
- 9 Eating disorders
- 10 Affects and alexithymia in medical illness and disease
- 11 Treatment considerations
- 12 Future directions
- Appendix
- References
- Index
11 - Treatment considerations
Published online by Cambridge University Press: 21 September 2009
- Frontmatter
- Contents
- Foreword
- Acknowledgments
- Acknowledgment of permission for use of material
- Introduction
- 1 The development and regulation of affects
- 2 Affect dysregulation and alexithymia
- 3 Measurement and validation of the alexithymia construct
- 4 Relations between alexithymia, personality, and affects
- 5 The neurobiology of emotion, affect regulation, and alexithymia
- 6 Somatoform disorders
- 7 Anxiety and depressive disorders and a note on personality disorders
- 8 Substance use disorders
- 9 Eating disorders
- 10 Affects and alexithymia in medical illness and disease
- 11 Treatment considerations
- 12 Future directions
- Appendix
- References
- Index
Summary
Medical and psychiatric patients with alexithymia or other deficits in emotional processing typically present major treatment problems for physicians and mental health professionals. In addition to deficits in affect expression and affect regulation, such patients manifest disturbances in inner self- and object representations and other aspects of self-regulation, which often lead to countertransferential or other interpersonal difficulties within therapeutic relationships. Their proneness to somatization may result in medical overinvestigation that can add an iatrogenic component to their illnesses; and their ‘affect storms’ or difficulty in relinquishing unhealthy affect regulatory behaviours, such as alcohol abuse or binge eating, may lead to feelings of frustration, anger, and helplessness in their treating physicians, nurses, or psychotherapists.
Based on extensive clinical observations, several therapists have concluded that alexithymic patients respond poorly to psychoanalysis or other insight-oriented forms of psychotherapy. Before the term ‘alexithymia’ was coined to describe these patients, Ruesch (1948) reported a poor response to insight psychotherapy which he attributed to an inability to connect verbal, gestural, or other symbols with affects and feelings. Horney (1952) similarly viewed a paucity of inner experience and the associated externally orientated mode of thinking and living a major impediment to psychoanalytic therapy.
- Type
- Chapter
- Information
- Disorders of Affect RegulationAlexithymia in Medical and Psychiatric Illness, pp. 248 - 266Publisher: Cambridge University PressPrint publication year: 1997
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