A SEARCH FOR THE AFFECTIVE DETERMINANTS OF CHRONIC URTICARIA
ROBERT J. SHOEMAKER M.D.1,
MACY I. LEVINE M.D.2,
WILLIAM G. SHIPMAN PH.D.3, , and
MARY A. MALLY M.S.S.4
1 Clin. Ass. Prof. of Psychiatry.
2 Clin. Ass. Prof. of Medicine.
3 Staunton Ass. Prof. of Psychology, now Staff Psychologist, Michael Reese Hospital.
4 Chief Psychiatric Social Worker, Staunton Clinic, School of Medicine, University of Pittsburgh.
1. Medical study of 40 patients failed to produce evidence of an allergic mechanism or a causative physical agent in the etiology of their chronic urticaria. 2. Chronic urticaria may be viewed as a regressive, physiological expression of unconscious conflict when previously operating mechanisms of defense have become inadequate to bind strong affect. Anxiety is the dominant affect in this disorder. 3. Regression from a predominate action level of tension discharge to an organ level of expression is dynamically crucial to the formation of chronic urticaria. 4. The prime affective force in chronic urticaria stems from a revival of abandonment fear and companion rage, called up in a state of helplessness engendered by a particular set of life circumstances. 5. The conversion process offers the most satisfactory explanation for the physical reaction of chronic urticaria among the patients in this series.
