PRIVATE CASE-BOOK OF AN M.D. by Curt S. Wachtel, M.D.
PRIVATE CASE-BOOK OF AN M.D. by Curt S. Wachtel, M.D. Mind/Psyche PRIVATE CASE-BOOK OF AN M.D. by Curt S. Wachtel, M.D. Amazing true case histories which detail cures of the ills of the body through the magic of the mind. is a complete reprint of the $5.00 hardcover edition. The Psycho-Medical Guide, Parts I & II, published by special arrangement with the author. BELMONT BOOKS First Printing June 1962 To my wife ELIZABETH WACHTEL whose cooperation and assistance made this work possible BELMONT BOOKS I published by Belmont Productions, Inc. 66 Leonard Street, New York 13, N. Y. © 1956 by Curt S. Wachtel, M.D., all rights reserved PRINTED IN THE UNITED STATES OF AMERICA Preface to the Belmont Edition Introduction PART ONE: THE MEDICAL DETECTIVE 1. Between Illness and Health The Woman Who Denies her Soul If I Could Only Have a Child Upside-Down Routine Sickens Four Pride and Pain 2. Symptoms "Sweating It Out" Always the Boss The Itch Female by Mistake 3. Accidents and Incidents Guilt and Self-Punishment A Belated Conscience Accident Prone Emory's Conundrum One Buyer's Ego A Grave Digger 4. Imprints The Baseball Fan Retarded Accomplishment Imprint Removed Superstition PART TWO: THE VOICE OF THE ORGANS Breakdown 5. The Skin Rash Marriage Produces Rash The Skin Speaks Out Warts Yield to Courtship Occupational Skin Reactions 6. Respiration Frail of Mind The Loser Humility Arrests Illness Pre-Natal Refugee 7. Heart and Circulation Hearts Break for Loved Ones Second Choice Forgotten Years The Eternal Triangle 8. Digestion Symbolic Confinements Business Over All Appearance Above Value The Colon Rules 9. Obesity—Leanness—Metabolism The Fat Cellist Mother Eats and Dies Daughter Starves and Lives The Unsuccessful Businessman 10. Cancer and Introspection Last Years of Happiness Two Years of Panic PREFACE TO THE BELMONT EDITION The word "private" places emphasis on the secret, unconscious urges, thoughts and desires of the sick person, thoughts and urges which the patient generally refuses to divulge to anyone, including himself. Without the knowledge of these hidden motivations the patient remains an enigma to himself. As long as this enigma is not solved, the process of healing or cure is prevented and/or the sickness will tend to recur, as long as the hidden motivation is not understood. The doctor has many ways and means to uncover hidden motivations within the patient Why does any person hide his motivations? For the same reason that you, the reader, do not want to admit certain things which you have done once or often, because you do not entirely agree with what you do or did. It need not be a crime which you hide. Suppose you are a woman with a beautiful bust. There is on your left breast what we doctors call an angioma. For the sake of simplicity you may call it a birthmark. You got so used to keeping it secret from everybody that you try to hide it even from your doctor, wearing slips high enough to cover your birthmark. One of my patients who needed to reduce never took off her undergarments, but never took off weight either. Once she stayed away from my office for longer than one year. When she returned, she was proud to report that eventually she had lost a considerable amount of weight She did not only look slender but sick. Therefore, I insisted that she give up hiding her breasts during my examination. I found a cancer which needed immediate amputation of that breast. The "private" reservation of this patient almost had destroyed her life. Had she given up this "private" reservation in time, she might have saved her breast and enormous amounts of anxiety and fear. Private Case-Book of an M.D. contains more secrets than "confessions" of sin and sex which fill the fiction magazines and books. In Private Case-Book of an M.D. you can trust that the reports are true, in the sense of correct and factual. A doctor has good reasons to be realistic, as only realistic interpretation of facts can help the patient. Psychosomatic cure is based upon the correct psychology of the patient, eliminating self-deceit and false justifications. The only sin in medicine is to act or live in contradiction to the law of nature. Of course we know that virtue or sin, good or evil practices in life are facts which influence health by way of the spirit. Spiritual medicine is one of the oldest forms of medical practice. The spirit controls the body by way of the inner process, the forces of the soul and conscience. The patient in the doctor's office preserves his privacy under all circumstances. It makes no difference for the medical truth whether the woman with the angioma and the cancer lived in Europe or in Los Angeles, whether she lived in any of the many places where I gained my medical experience, in Europe or in this country, whether it happened in 1914, 1941 or yesterday. The patient may have come from New York, from Canada or Mexico or elsewhere. As long as the name and address are not given you can look for the needle in the haystack and be certain that any similarity in a case of your acquaintance must be accidental. Every case is different, every inner process is different from the other one. There are no two cases or two persons alike, which makes this kind of medical practice so interesting. Every case is a new challenge to find the correct working of the inner process, otherwise there would be no cure. While every case is different, certain typical ways of thinking occur again and again. Every excitement may cause an increased output of adrenalin and more or less sudden increase of blood pressure. You can be certain to find this phenomenon in your own behavior, but from here on things vary. If your stomach is the weakest organ in your body, you may develop an indigestion. If your nerves are the weakest organ, you may show a tremor or tensions. According to circumstances, your tremor or tension may show up in your head, hands or face. Or the tension may be in the parts of the body which are commonly covered by clothing, for example, in your chest. Then your breathing may be affected and further influence the way you speak, the disturbance of your speech may handicap your efficiency in business. The realization of this effect may cause you to become depressed. This book has been very helpful in the past in enhancing the mutual understanding between the patient and his physician. I hope it will continue to help many more persons who wish to discuss their problems with the doctor. Every reader will be interested to learn the good reasons why one does not need to be sick in order to profit from the psycho-medical insight which results from the psychosomatic understanding of one's emotional shortcomings. It is just for this reason that so many successful people in the field of journalism, literature, the arts and professions, who are not sick, undergo psychosomatic guidance. —Curt S. Wachtel, M.D., F.N.Y.C.S. New York City April 1962 INTRODUCTION WHY PSYCHOSOMATIC MEDICINE? A Word to the Patient: Psychomatic medicine is the medicine of the future practiced today—but only as yet by a small number of specialists. The time has passed when a pat on the shoulder, a little psychology added to the traditional bedside manner can be mistaken for this new branch of medicine. The psychosomatic physician uses and controls both the known as well as the hidden forces of nature which work upon body and mind of the sick person. Psychosomatic medicine is still a pioneering field and has not yet become part of the regular curriculum of medical schools. It may, therefore, be helpful that I explain the correct meaning of the word, "psychosomatic," and the relations between soma, psyche, and soul before I start to discuss individual patients' life experiences. Persons who are seriously ill and others who live between illness and health are overcrowding institutions and hospitals. Many of them who do not respond to the traditional methods of treatment can be cured by psychosomatic medicine. Soma is just another word for body. Bodily injuries cause the person to become apprehensive, anxious, fearful, concerned with his immediate and distant future and possible disability. There is a point, or surface of contact inside the person, where bodily injury is transformed into psychic suffering. If this process is reversed, psychic and mental apprehension cause physical symptoms or psychosomatic illness. The psyche, broadly speaking, is the mental and emotional setup of the person. The psyche comprises the functions of the brain and nervous system and also certain functions of the endocrine glands. The psyche acts similar to a communication system with a central switchboard and interconnecting wires. This system by itself, no matter how ingenious and perfect it may be, never creates ideas. It can only transmit ideas and messages. The psyche is not identical with the soul. The soul in medicine is the source of creative thinking and spiritual understanding. It is responsible for vital energy, judgment, free will and consciousness, for faith, hope and charity, spirituality and for all the motivations which distinguish man from animal. As long as these forces cannot be attributed to specific body organs or organ systems, they are to be related to the human soul. The soul is the carrier of mental and other functions in the same way that the atom in physics, the molecule in chemistry and electricity in engineering, though never directly observed, are known by their effects. Only that psychosomatic medicine which takes into consideration the soul, together with the psyche and soma, treats the whole man. Psychosomatic treatment embraces all known methods of modern diagnosis and therapy. Whenever these methods of traditional medicine are needed, they are combined with the active correction of the deep-rooted psychological motivations of the sick person. To take advantage of the curative power of the subconscious, we proceed from the surface into the deeper layers of consciousness. We locate the disease-producing process in the subconscious sphere and start the curative process at the same time. We establish the liberation of the soul through psychological guidance and counselling and, thereby, transform the new and healing motivation into a permanent force. Psychosomatic practice has profited from psychoanalytical and psychiatric research and experience. But psychoanalysts do not apply medicinal treatment. Psychiatry, on the other hand, takes advantage of the entire knowledge and apparatus of scientific medicine and is definitely on its way, ahead of all other specialties, to adopt and absorb the psychosomatic approach. The psychosomatic physician studies and knows what is going on inside the patient and what forms the chain of inner causes and effects between the origin of a disease and the resulting clinical signs and symptoms and the pains and sufferings of the patient. Accordingly, psychosomatic treatment does not rely on the imposition of therapeutic measures alone, but also appeals by specific methods to the intellect and will of the patient and obtains his understanding cooperation. Thus, the patient's mind is persuaded to act as the strongest health-producing force and, thereby, mobilizes all the restorative powers inside his personality. Psychosomatic illness, it has been estimated, may be found in as many as 80 percent of all patients who enter any doctor's office. When traditional methods fail, these patients need psychosomatic treatment. No doctor can afford to ignore this new approach to medicine. No patient needs to continue on the desperate sufferer's merry-go-round, going in circles, switching doctors, juggling drug jars, and trying to find a miracle cure in a capsule. Psychosomatic medicine holds out a two-fold promise for all patients: For Today: Cure for many more individuals suffering from disease which they believe to be incurable. For The Future: An increase in the number of physicians, surgeons and specialists in all branches of medicine, who will have absorbed the psychosomatic approach as an essential and integral part of their medical thinking and skill as well as medical practice. It is my firm belief, after many years of research and study, that the world, at large, is now ready for the acceptance of psychosomatic medicine. A Word to the Doctor; Psychosomatic medicine is a highly complex specialty to which all other branches of medicine contribute detailed information. It involves physical, chemical, physiological, psychological, psychiatric and environmental factors. The fact may be stated that, in psychosomatic research, experimental conditions can seldom be established at the will of the researcher, as in the case in physics, chemistry and some branches of medicine. Only life itself creates the situations which we may analyze. Whether the solution of a patient's problem is final and successful can often be ascertained only when the doctor is kept informed about the patient's development for a long time after the treatment has been completed. It is obvious that psychosomatic medicine is not confined to the restoration of a temporary or transitory disturbance such as a diseased gall bladder, a duodenal ulcer or a heart ailment. Psychosomatic treatment is always directed towards the complete and permanent adjustment of the total person of the patient to his life situation and towards the establishment of the patient's ability to face any future life situations successfully. The final outcome of a cure always depends upon the patient's effort and ability to acquire control of his emotional system as well as of his mental and spiritual judgment and will. In this book I deal with individual patients and their problems which have been followed up for as long as was necessary so that it is possible to judge the phenomena and outcome of these experiences retrospectively. The psychological workings and motivations which lead into and out of psychosomatic illness in the narratives of patients' stories are condensed in order to bring out into the open what is going on inside the patients. In so far as many of the psychosomatic phenomena have not been described elsewhere in scientific literature, this study has not been planned as a popular simplification, still less as a collection of success stories. Nor do I promise or wish to give the impression that any reader, merely by reading the book, will be enabled to cure his own psychosomatic illness. The scope of the book comprises the study and observation of the inner process by which emotional and mental activities are transformed into bodily symptoms and illness. Or, in the opposite direction, the inner process may become somatopsychic, when bodily phenomena and suffering affect the emotional thinking and other mental functions of the patient. The biological internal link between somatic, psychic and spiritual phenomena is the essential part of psychosomatic illness. It serves the purpose to proceed from the simpler psychosomatic developments towards the complex interrelations which occur between conscious and subconscious motivations on the one side and bodily phenomena on the other side. The first part of this volume deals with transitory symptoms of suffering and disease which are caused by emotional, mental and spiritual problems of the individual. The second part presents experiences of causal relations observed between apparently physical conditions and mental tendencies of which the person is mostly unaware. It is obvious that situations become more complicated as we proceed to deal with psychosomatic conditions at different periods of life. Th,e psychosomatic approach will become part of all the specialties which are limited to certain periods of life, such as pediatrics, obstetrics or geriatrics. A volume of limited size cannot nearly exhaust this subject. Psychosomatic medicine is today a specialty in its own right. The day will come, however, when all the special branches of traditional medicine will feel the need to integrate their striving for practical efficiency with the psychosomatic conception of the patient and his problems. PART ONE THE MEDICAL DETECTIVE CHAPTER ONE: BETWEEN ILLNESS AND HEALTH Proceeding on the premise that truth is stranger than fiction and that what interests most people most—are other people, their fortunes and misfortunes, I have selected from my records and recollections the life-experiences of patients whom I have treated in the course of more than thirty years of my practice in psychosomatic medicine, long before this modern day appellative became the subject of popular interest. Truth Is Stranger Than Fiction There are many physical conditions which are directly brought to the doctor's notice and recorded as more or less stereotyped "case histories." Actually, all of them form psychological situations in the lives of human individuals. And so, in this book, I report them as true life-experiences which affect the entire personality of the individual patient Each situation may be experienced by more than one, even by many persons. Not the situation, but the individual character and reaction pattern of the patient—no two of them are ever alike—cause the variations and singularity of life-experiences. I have carefully disguised the personalities of the patients, not only their names, but also the incidental and environmental circumstances. However, I have not allowed these minor changes to alter the true and essential motivations and actions of my patients. Any resemblance to any situation or person, whether living or dead, will be purely coincidental. Some of these experiences are touched with tragedy, some with malice, some have an element of humor, others are humdrum, still others lurid; but all have one common denominator—they occurred in the lives of real people. It is ray sincere hope that this book will induce the reader to glean from its pages the message that we are largely responsible for our own fate. When Traditional Medicine Fails After the methods of traditional medicine have been exhausted without bringing relief to the patient, psychosomatic medicine may bring results. When this happens, the psychosomatic physician appears to these sufferers as the specialist for patients in despair. A despairing patient needs both organic and psychic restoration for bis "dis-ease" or "dis-order." These everyday words portray the lack of harmony in the make-up of the person who lives between illness and health. I have tried to keep these pages uncluttered and free of technical phrases and terminology. I have also tried to prevent their becoming choked with theory and prolonged explanation. I have felt, however, that a certain amount of preliminary explanation at the beginning and a summary at the end of each chapter was necessary. For this I beg the reader to bear with me and to keep in mind always that I am not a story-teller. I am- a doctor who reports medical experiences. The Screen Within Yourself Patients with problems often live for considerably long periods of time between illness and health. What is or has been going on inside their personalities is the inner proces… truncated (254,202 more characters in archive)