The connection between the brain and the heart is biologically embedded through evolution and is established during embryonic development. In this interactive context emotional awareness is based on functions of the autonomic nervous system. Bio-psycho-social factors influence the body and mind, in particular cardiac health. They challenge humans to resist and to be resilient to emotional stress exposure. Maintaining good health presupposes neuropsychophysiological stability. Current research focuses on emotional dysfunction. Therapeutic goals include detection of causes as well as the increase of individual stress endurance. Emotional dysfunctions are opaque preconditions, that can damage cardiac health. Symptoms of increased stress vulnerability appear as psychosomatic heart sensations and heart complaints and are likely associated with depression and anxiety. Patients who suffer from medically unexplained physical symptoms (MUPS) currently remain without cardiological diagnosis or psychotherapeutic treatment. They have an increased morbidity risk as well as an increased hazard ratio for cardiovascular mortality. One can assume, that MUPS are the missing link between early psychosomatic symptoms and the consequential development of cardiac manifestation that in later stages become a clinically verified cardiovascular disease, e.g. Takotsubo stress cardiomyopathy. As cardiology reaches its limitations in diagnostics and treatment of cardiac patients with mental or psychosomatic comorbidities as well as of patients with MUPS, this subject is explored from a psychotherapeutic perspective based on scientific literature research. The correlation between psychosomatic heart projections, bio-psychosocial aspects, e.g. deregulation of the autonomic nervous system, present type-D-personality with or without alexithymia, and an increased prevalence of cardiovascular disease is investigated. Further, the hypothesis is tested, whether these heart complaints are caused by an impairment of emotional awareness, that additionally results in physical and psychological suffering due to chronic uncompensated stress aggravated by time. The results could provide adjuvant psychotherapeutic diagnostics and focal treatment options to be applied complementary to (psycho-)cardiology and establish an interdisciplinary treatment for people affected. The duality of the treatment shows short comings in their institutionalisation, which should be edited.
Keywords: Nervus vagus, autonomic nervous system, cortisol, type-D-personality, emotion, alexithymia, slights and offenses;
Cite this as: Teuschl, S.L. (2018). Psychotherapie als Komplementärversorgung in der Kardiologie. Somatisierte Leidenszustände und die Grenzen ihrer klinischen Befundung. (Abstract). Unpublished doctoral dissertation, Sigmund Freud PrivateUniversity Vienna. URL: https://www.psychotherapie-teuschl.com/