Psychosomatic Medicine 1:139-152 (1939)
© 1939 American Psychosomatic Society

Psychoanalytic study of a Case of Essential Hypertension

¹ Institute for Psychoanalysis, Chicago

The day by day blood pressure fluctuations of a 47 year old male suffering from a chronic depression, chronic alcoholism and essential hypertension, have been compared with the daily psychoanalytic material. The patient's overt personality has been described and the underlying psychodynamic personality structure reconstructed and explained in the light of the emotional development which led up to the adult personality.

A definite correlation has been found between emotional tensions and fluctuations of the blood pressure. The nature of the emotional tensions has been identified as inhibited, but not deeply repressed aggressive impulses directed partly inward against the patient's own person in the form of depressions, partly turned outwards in the form of hostile feelings. These emotional states were mixed with an apprehensive worrisome state of mind. Finally it was observed that during a period in which the patient was in an exceptionally calm state, his blood pressure was definitely lower and showed considerably smaller fluctuations. During the last period of treatment, with the diminution of the emotional tensions, there was a slow but definite decrease of the day by day fluctuations, and a slow downward tendency of the average blood pressure level.

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