Case Of Nancy B

Nancy B, a girl of fifteen who had severe dysmenorrhea and excessive bleeding, was put in a deep trance and discussed with the doctor her first menstrual period. This had occurred at the age of eleven or twelve. There was excessive bleeding, although she experienced little pain. A great furore was raised about it, however, and she was hospitalized and given hormones by mouth. This was a very exciting experience for Nancy. Since that time, all her periods had been accompanied by very severe pain and unusual amount of bleeding.

The fact was discussed that often young girls of eleven, twelve, and thirteen do not have a standard body reaction; thus, some months they need to have excessive bleeding, other months they need to have little bleeding; some months they need to have more contractions, and others, fewer contractions. Following the discussion, the patient was told "Now you're a grown girl and, of course, your body should have learned by now. It can learn within the next thirty days exactly which mechanism is necessary."

Nancy's next period was painless and site bled about 60 percent of the amount she had previously, probably the normal amount for her. She came back to see the doctor after that period and the possibility of the body learning things first one way and then another was discussed. The second month she again had a relatively painful period, although not as painful as originally; furthermore, she lost almost as much blood as she had been doing. It was pointed out to her that this actually could be an excellent thing, since she was experiencing various ways of learning.

Her third period was entirely normal and free from pain. Nancy was told that she might "slip up" again. She was also told that, since she was going to be menstruating for many, many years, it was almost inevitable that she would miss some periods because of illness, accidents, or pregnancy, after which she would start to menstruate again. These things were explained in detail to allow for the possibility of their occurring without disturbing her emotionally to the point where she would revert to the old painful and excessive bleeding pattern.

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