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Taylor, G.J. (1996). Psychosomatics, Psychoanalysis, and Inflammatory Disease of the Colon: Charles C. Hogan, International Universities Press, Madison, CT, 1995, 290 pp., $45.00.. J. Amer. Acad. Psychoanal., 24(2):374-377.
(1996). Journal of American Academy of Psychoanalysis, 24(2):374-377
Psychosomatics, Psychoanalysis, and Inflammatory Disease of the Colon: Charles C. Hogan, International Universities Press, Madison, CT, 1995, 290 pp., $45.00.
Review by: Graeme J. Taylor, M.D.
This book is the fifth monograph in a “Stress and Health Series,” which explores the relation between psychoanalysis and psychosomatic medicine and the role of life events and personality variables in illness and disease. Whereas some of the earlier monographs considered a wide variety of medical disorders, this current volume focuses on inflammatory disease of the colon.
The book is divided into three main parts. The first is essentially a medical update on inflammatory disease of the colon; the author reviews the somatic, genetic, epidemiological, and psychopathological aspects of ulcerative colitis and Crohn's disease, and describes pharmacological and surgical approaches to treatment. The second part is devoted to some of the complex theoretical issues concerning mind-body relations. Within this section are chapters on modes of studying, organizing, and conceptualizing psychosomatic data, including discussions of Cartesian dualistic interactionism, isomorphism, and linguistic parallelism. Other chapters review the theory of conversion, the concept of stress, the alexithymia construct, and ideas about regulation and disregulation. Hogan returns to clinical data in the third part, in which he outlines his formulations of the psychodynamics and object relations of patients with inflammatory bowel disease (IBD), and describes his psychoanalytic method of treatment. Transference and countertransference issues are discussed. The book ends with a short Afterword in which the author reiterates the need for physicians to consider the “subjective” or psychological worlds of medically ill patients, but he downplays the use of quantitative methods for studying this dimension.
The most valuable part of the book is the section on treatment. The author is clearly a highly skilled and experienced clinician, and his approach and treatment outcome results should encourage many more analysts to engage IBD patients in psychoanalytic therapy. Like several other psychoanalytic psychosomaticists, Hogan recognizes that the psychopathology associated with IBD usually differs from psychoneurotic pathology; it involves primitive parts of the personality and is related to the pregenital and preverbal period of development.
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