Glycaemic dysregulation and relational/affective dysregulation in a patient with diabetes mellitus.
Recent psychoanalytically inspired psychosomatics conceptualises somatic disorders as disorders in the internalised relationship with a regulating object, causing physiological/affective dysregulation. In diabetes mellitus, measurements of blood glucose allow close monitoring of a form of somatic regulation. Several authors have reported parallels between glycaemic oscillations and relational vicissitudes, in both experimental and clinical settings. Mothers of diabetic patients report a history of misattunement in feeding patterns, while similar difficulties, on the symbolic level of accepting mutual communication, are found in the analysis of adult patients. More or less conscious opposition to glycaemic regulation appears to be linked with problems in distance regulation with the object. The author reports a clinical case that gives evidence of this parallelism; the patient presents a marked non-integration and dysregulation of relational and separateness needs, which both emerge, with respect to the analyst and to other objects, in a quickly alternating, violent, juxtaposed fashion reminiscent of descriptions of disorganised attachment or of borderline patients. These oscillations are closely paralleled by oscillations in glycaemic control, where violent withdrawal from relationships corresponds to physiological and behavioural disruption of glycaemic regulation patterns. Improved mentalisation and integration of the different tendencies in the course of analysis brings to both the possibility of stable affective involvement and improvement in diabetic control.
Solano
L
L
solano@axrma.uniroma1.it
D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology*; D003920:Diabetes Mellitus / Q000523:psychology*; D006801:Humans; D007003:Hypoglycemia / Q000523:psychology / Q000628:therapy*; D007398:Interpersonal Relations; D008297:Male; D012649:Self Concept; D014754:Violence