Abstract
Alexithymia is a concept proposed by Sifneos to express psychological characteristics of some psychosomatic disorders which are different from neurosis. These psychological characteristics are:
1) distorted emotional functioning
2) distorted cognitive functioning
3) distorted object relationships
Case: As the patient, a 20 year old female nursing student, complained of coldwater pain in the left first molar lower tooth, she was given ordinary oral treatment. However as oral discomfort, anxiety and asthenia were complained at each therapy session, the Pt was referred to the author for a psychosomatic approach. Though expressing some fear of intraoral injection, the Pt was requesting prompt treatment. However, the actual treatment did not progress as weariness and difficult breathing were experienced by the patient.
Desensitization by image also proved to be difficult, thus therapy was switched to desensitization in-vivo, and according to the Pt, her discomfort varied according to her physical condition. Upon further listening it became clear that one of the factors influencing this condition was the conflicting relationship with her mother.
Moreover, it was observed that she tried to confirm the rightness of her perceptions for feeling the irrationality in some events, which indeed, were irrational. She would also talk about other events with her mother but only in a matter of fact way and emotion lessly, where normally an emotional outburst would be expected. Presently, oral treatment through in-vivo desensitization is becoming more practicable through a process of acceptance and support.
According to our experience, patients who react with discomfort at dental treatment are usually full of anxiety and express their fears of oral treatment overtly.
However, this patient had no complaints at the beginning of therapy & seemed to be a normal patient. But once starting the treatment she would overreact through ANS responses to oral treatment stressors, and the degree of such responses was influenced by events in the family, as it was later found through interviews. Those above mentioned characteristics suggest the possibility of a personality with alexithymic tendencies.
