Psychosomatische Gesichtspunkte der Hypertonie

Abstract: According to Alexander, patients with hypertonia often live in a conflict between violent agressive-hostile impulses and passive-dependant tendencies which are equally strong. Ostfeld and Lebovits described unstable personalities with impulsive hypochondriac-hysterical traits. Gressel on the other hand emphasized an obsessive-compulsive behaviour and a self-confidence which is below the normal level. Different hypertensive persons can be found among the four basic types, which Riemann takes as a basis in his reflections about fear. In addition to this, there are socio-structural conditions, which cause a disturbance of the balance of the organism. Psychosomatic effects are not present with high blood pressure in the important first phase, which course is asymptomatic. 31% of the hypertensive persons are unaware of their disease. High blood pressure is closely connected to overweight and an increased consumption of sodium chloride. According to v. Eff, the essential hypertonia is a disease which is characterized by an inherited hyperreactivity of the hyperthalamic sympathic centre, which is manifestes by the personality and the surrounding and which is fixed by peripheral mechanisms. The fixation of a hypertonia which is unstable in the beginning is done by the kidneys, which function as a long-term barometer. In this way, a disease which is of a psychosomatic nature in the beginning becomes a somatically fixed disease. lf arteriosclerosis is developing and secondary diseases in the brain, the heart and the kidneys occur, the disease without symptoms becomes an illness, which gets an own psychosomatic dynamic.In a therapy, the boredom of a stay in hospital or the removal of conflict situations with corresponding soothing influence have an anti-hypertensive effect. Jacobson used the progressive muscular relaxation for the treatment of high blood pressure. Benson developed a method, which follows the transcendental meditation or its spiritual claim. Self-suggestion or foreign-suggestion, as exercised in autogenous training or in hypnosis also showed a good success. The extraordinary good effect of placebos in therapeutical studies showed, that the right and rational starting point of the physician patient relation has an immense anti-hypertensive effect. The aim is a soothing influence, a discussion of personal problems and the insight into the causes of fears and emotional reactions as wells as the reduction of stress. As measures of behaviour therapy, bio-feedback and the operant conditioning are used. These methods are only effective for the period in which they are employed.

Keyword(s): Arterielle Hypertonie

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