Beyme, F. (Basel). ‘Die Psychosomatik der Kranken mit Migräne und Kopfschmerz’ (The psychosomatic condition of patients with migraine and headaches). Chapter from Praktische Psychosomatik. A. Jores (Ed.). Bern, Stuttgart, Wien, Verlag Hans Huber (1981).

The book Praktische Psychosomatik is edited by A. Jores, a well-known writer on anthropological medicine. The author of this chapter, P. Beyme, gives a thorough and well-presented account of his research and that of other workers into headaches in general and migraine in particular.

Among 15,000 patients suffering from headaches 90 per cent presented a functional cause for their symptom. Beyme divides functional headaches into three groups:

1. (i) vascular headaches (cephalea vasomotoria) occurring predominantly in female patients;

2. (ii) muscle contraction and tension headaches;

3. (iii) neuralgic headaches.

He gives a detailed account of the causes of vascular headaches with interesting clinical examples (based on research by Jores and H. G. Wolff):

(i) change in the weather; (2) menstruation; (3) alcohol; (4) tyramin (a substance in some cheeses); (5) hypoglycaemia; (6) bottled up aggression; (7) anxiety about the future; (8) sudden relaxation (weekend and holiday ‘let-down’ headache); (9) setting one's goals for achievement too high.

The author describes four types of treatment: medication, autogenic training (J. H. Schultz), symptom-centred psychotherapy, and psychoanalysis. It does not become clear which criteria determine his choice of treatment.

Beyme challenges Eysenck's claim that psychotherapy is ineffectual. With the help of statistical tables, including control groups, Beyme claims that psychoanalysis as carried out in a New York hospital produced no results, whereas symptom-centred psychotherapy, which makes the patient conscious of his anxieties and gives him advice as to how to conduct his life, produced improvement and, in some cases, a complete cure of the symptom.