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Taylor, G.J. (1993). Clinical Application of a Dysregulation Model of Illness and Disease: A Case of Spasmodic Torticollis. Int. J. Psycho-Anal., 74:581-594.

(1993). International Journal of Psycho-Analysis, 74:581-594

Clinical Application of a Dysregulation Model of Illness and Disease: A Case of Spasmodic Torticollis

Graeme J. Taylor


A case of spasmodic torticollis is described to demonstrate the clinical usefulness of a new theoretical model of somatic illness and disease. Based on a conception of the living organism as a self-regulating system, the model attributes somatic disorders to a variety of regulatory disturbances including deficits in affect regulation and in the ability to maintain a stable and cohesive self. Throughout the analytical treatment, attention was given to repairing deficits in the patient's self-organisation, and to elevating chaotic impulses and inchoate emotions from a primitive sensorimotor level of experience to a mature representational level where they could be valued for their signal function and modulated through imaginal activity and communication with others. Analysis of the patient's pathologic internal object relations modified his self-organisation, and enabled him to establish regulatory interpersonal relationships that complemented his enhanced self-regulatory capacities. These changes were accompanied by a gradual resolution of the patient's torticollis.

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