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Special Article

Affects, Trauma, and Mechanisms of Symptom Formation: A Tribute to John C. Nemiah, MD (1918–2009)

Taylor G.J.

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Department of Psychiatry, University of Toronto and Mount Sinai Hospital, Toronto, Ont., Canada

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Psychother Psychosom 2010;79:339–349

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Article / Publication Details

First-Page Preview
Abstract of Special Article

Received: March 01, 2010
Accepted: September 03, 2010
Published online: August 20, 2010
Issue release date: October 2010

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Abstract

John Nemiah was interested in the impact of emotionally traumatic events on mental and bodily processes and in conceptualizing the psychological defenses and deficits that contribute to the development of psychological and somatic symptoms. He viewed dissociation as the central psychological mechanism in the formation of a spectrum of symptoms, and conceptualized alexithymia as a deficit in the cognitive processing of emotion such that stress-induced arousal could bypass the psyche and produce somatic symptoms. This article briefly reviews some of Nemiah’s conceptual ideas and relates them to several new theories and concepts and findings from empirical research. His concept of the ‘psychic elaboration’ of emotion is consistent with contemporary theories of the cognitive processing of emotions that emphasize the importance of imagery and linguistic symbolizations. Alexithymia is inversely related to mentalization and is associated with insecure attachment styles and emotional trauma, which influence the capacity to regulate affects induced by stressful events. A multiple code theory of emotional information processing links psychological and somatic symptoms to various degrees of dissociation within and between the elements comprising emotion schemas and to compensatory attempts at repair. Recent studies support Nemiah’s view that alexithymia and intrapsychic conflicts may both contribute to the pathogenesis of panic attacks. There is also substantial evidence of an association between childhood trauma and the development of somatic disease in adult life. Secure attachments and well-developed capacities for symbolization and affect regulation seem to render individuals more resilient to the traumas and stressful events of everyday life.

© 2010 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Special Article

Received: March 01, 2010
Accepted: September 03, 2010
Published online: August 20, 2010
Issue release date: October 2010

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS


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