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The British Journal of Psychiatry (1965) 111: 841-858. doi: 10.1192/bjp.111.478.841
© 1965 The Royal College of Psychiatrists
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A Psychosomatic Study of Writer's Cramp

A. H. CRISP M.B., M.R.C.P.E., D.P.M.1 and H. MOLDOFSKY M.D., D.Psych.2

1 Lecturer, Academic Psychiatric Unit, Middlesex Hospital Medical School, London, W.1
2 Research Assistant, Academic Psychiatric Unit, Middlesex Hospital Medical School, London, W.1.

The concept of writer's cramp is examined in relation to some innate and acquired functions of the upper limbs and the clinical literature. Seven patients with writer's cramp have been studied longitudinally and mainly within the treatment situation. Each study was monitored by a psychiatrist, who interviewed the patient weekly and quantified some aspects of the patient's "transference" to the therapist during treatment. The patient also self-rated his or her emotional and symptom state weekly. All the patients were found to have excessive obsessional and dependency characteristics and to have particular difficulties in expressing their anger in important interpersonal relationships and in their work. Emotional conflict, frequently centred around their need to write under frustrating but unavoidable circumstances, appeared to be associated with the onset of their writing difficulties. In treatment, psychotherapy was conducted within the framework of a reeducation programme. All patients responded favourably during treatment sessions, and in six patients there was also some generalization of this response outside of therapy. The role of "transference" in therapy and its importance for symptomatic improvement is discussed. A psychosomatic hypothesis as to the possible origin and development of writer's cramp is proposed, and an appropriate supportive psychotherapeutic re-education treatment programme is suggested.




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A. J. Barsky and J. F. Borus
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Ann Intern Med, June 1, 1999; 130(11): 910 - 921.
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Copyright © 1965 The Royal College of Psychiatrists.