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This psychiatric study of fourteen patients with disseminated lupus revealed that 'the threat of the loss of a significant personal relationship regularly provoked an exacerbation of the complaint of pain and disability'. This reaction results from an 'early life reaction to loss in the mother-child relationship, in
which passive longings are denied, and hyperindependence develops'. Exacerbations of disseminated lupus occur concomitantly with failure of the striving for independence and subsequent failure of efforts at integration by the ego. Organic cerebral changes contribute to this failure.