Construing the unspeakable: A constructivist approach to catatonia by means of modified Landfield categories

Heinz Böker*, Cordula von Schmeling**, Andrea Eppel**, Cynthia Lenz**

*Psychiatric University Hospital Zürich (Switzerland), **Department of Psychosomatic Medicine and Psychotherapy, University of Frankfurt/Main (Germany)

Abstract
Personal constructs of catatonic patients after recovery from the acute state of disease were investigated with the repertory grid-technique and compared with those of non-catatonic schizoaffective and depressive patients. The sample consists of IS catatonic patients, 22 schizoaffective, 16 unipolar and 23 bipolar depressive patients as well as of 32 psychiatrically healthy surgical controls. The contents of the personal constructs were analysed by means of modified Landfield categories.
"Self" and "Ideal self" in catatonic patients were characterised by significantly higher emotional responsiveness and increased affective sensibility than in all other groups. The element "me in the acute catatonic state" was described as chaotic, isolated and insecure showing stronger negative tendencies than in all other groups.
Increased emotional responsiveness and affective sensitivity in catatonic patients could be considered as specific markers of personal constructs in these patients. Catatonia with its predominance of psychomotor symptoms may be understood as the catastrophic result of the collapsing cycles of construction in psychoses.

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