Torpidity with ulcerative colitis. Sexual attitude in ulcerative colitis

It should immediately be noted that none of the described disorders is characteristic only for ulcerative colitis, since they are also found in other diseases, as well as in practically healthy people. It is not a matter of individual features of behavior, but of their preferred combinations. Many representatives of the psychosomatic direction write about a fixed personality type, regarded as a too static concept, while in the process of a serious illness significant changes in personality traits can occur. So, torpidity can be replaced by irritability, hysterical disorders of behavior or extreme sentimentality, tearfulness. The first acquaintance with patients was usually accompanied by their hasty and somewhat monotonous story about the course of the disease and the delayed start of treatment due to the erroneous diagnosis of dysentery. Outwardly, the sick looked calm, but inwardly they were full of bitterness and indignation. The lack of expressive manifestations of emotions in some cases reached a degree of pronounced hypomimicity. Patients with ulcerative colitis often have little contact and are closed, sinton and extroverted individuals were relatively rare, moreover, this could be a purely ostentatious, compensatory manifestation, masking egocentrism. Outwardly calm patients, with careful questioning, managed to reveal a sense of hopelessness and despair; quite willingly talking about somatic symptoms of the disease, patients with questions about their mental state became laconic and restrained. In some cases, we suggested that patients make written biographies or ask questions about how they reacted to any particular situation. In biographies, patients with their characteristic thoroughness cited a number of interesting details, while displaying well-known artistry. Patients were emphasized politely, often used medical terms in the conversation, avoiding any rude expressions. At the beginning of the disease, they often hid the presence of blood in the stool even from close relatives. The squeamishness of patients sometimes reached a degree of obsession. One patient accidentally dropped the pills at first scraped off with a knife, and then began to wash. Sometimes the correctness of the patients was purely external: internally they were full of bitterness and aggressiveness, more often irritability manifested itself in relation to the junior staff, which in such cases made it difficult to care. In 5 observations, a rather pronounced tendency toward litigation, which was quite utilitarian, could be noted. There was no abstract legal search in any case. “Fixed on mother”, “children’s desire for patrons and authorities” (Groen, Engel and other authors) may be explained by the fact that the disease makes patients completely helpless. Many patients in childhood were deprived of their fathers and rather painfully reacted to this. We have not received any convincing data on the period of early childhood; in some cases, there was a fixation on difficult experiences, but this concerned later childhood. This, apparently, is explained, on the one hand, by the characteristics of the personality of patients, and on the other, by a too gloomy assessment of the past due to the presence of depression. So, one patient at the age of 11 became infected with gonorrhea from her mother, it became known to other residents of the village and other children teased her “contagious”. At the age of 34, the patient spoke of this as the most difficult memory. The patient did not marry for a very long time, considering herself “contagious,” accusing her mother of “spoiling” her life. Sensitivity of patients sometimes became especially distinct when questioned about sexual life; men became especially withdrawn, confining themselves to the words: “Like everyone else,” “no worse than others.” In women, sexual issues often occupied a secondary place, they got married late, after much hesitation. Some patients had exaggeratedly perfect ideas about family life. In many foreign countries, sexual problems of patients with ulcerative colitis are assignedunreasonably large place. The well-known indifference of seriously ill patients to sexual life is seen as a manifestation of “general infantilism” and “emotional immaturity”. In our observations, in addition to patients with completely normal sex life or frigidity, there were patients who, on the contrary, complained about the insufficient potency of the husband, and in some cases men reported increased sexual activity. Disease of ulcerative colitis caused a significant weakening of potency, therefore, there could be a “generalization of current experiences in the past,” which was used by the authors in evaluating ulcerative colitis from the perspective of Freud’s teachings.

event_note September 3, 2019

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