Psychosomatic Medicine 13:140-146 (1951)
© 1951 American Psychosomatic Society

Relationship Therapy in Essential Hypertension

Psychosomatic Conference of the Cincinnati General Hospital

¹ Departments of Psychiatry and Internal Medicine of the University of Cincinnati College of Medicine and Cincinnati General Hospital
² Departments of Psychiatry and Internal Medicine of the University of Cincinnati College of Medicine and Cincinnati General Hospital; Psychosomatic Medicine and Instructor, Department of Internal Medicine

The case of a 43-year-old man with benign essential hypertension, complicated by angina pectoris and a cerebral vascular accident has been presented. Personality study revealed that the patient had a strong need to assert his masculinity as a screen to his repressed passivity. The primary dynamic conflict centered around situations in which his status as an authoritative figure was undermined, or he was demeaned by individuals in authority, resulting in severe blows to his self-esteem and pride. Hostility engendered during these conflicts appeared to be at least temporally related to the onset of his hypertension, and to several of the complications arising therefrom.

During the course of a twelve-month period of relationship therapy in which the internist assumed the role of a supportive, nonauthoritative figure, the patient has shown symptomatic improvement and a slight lowering of his blood pressure. He has been able to pass through two rather stormy, dynamically meaningful life situations with no evidence of progression of his disease.