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The clinical characteristics of 20 golfers suffering from golfers' cramp or the "yips" are described. The typical description is that of a middle-aged golfer who has played competitive golf since his teens and develops the problem during a tournament in the form of a jerk, spasm, or freezing of movement while putting or chipping, with the rest of the game being relatively unaffected. The problem generally takes a chronic fluctuating course, and a number of 'trick' strategies are partially or fully successful. In this study, the subjects were compared with a matched group of 20 unaffected golfers on a number of indices of psychopathology; no significant differences emerged. The more severely affected golfers also did not differ significantly from the mildly affected ones, except on the subjective report of anxiety. These data support the argument that golfers' cramp is not an anxiety disorder or a neurosis. The important role of anxiety and arousal in its manifestation is, nevertheless, recognized and its pathophysiology speculated upon.

As there is a variety of psychic and somatic variables in its genesis, the writer's cramp could be a syndrome of different subtypes. Therefore 62 former psychotherapy-patients with writer's cramp were examined according to a design of several dimensions in order to find out if there were any subtypes. The parts of the examination were exploration, structural interview, neurological examination, psychological examination of the personality, examination of some electrolytes in serum and radiograph of neck spinal column. Different multivariate statistical methods isolated two subtypes of patients with writer's cramp. The first group comprises patients with fine and/or big dysfunctions of motor activity, the symptoms are independent of psychic factors or of psychotherapy. The second group is characterized of a monosymtomatic writer's cramp, of a neurosis and of remissions of motoric symptoms following psychotherapy. The examination shows that fine and/or big dysfunctions of motor activity which often co-occur the writer's cramp are important criteria for differential diagnosis and indications.

In recent publications writer's cramp is mostly seen as a "focal dystonia", which denotes a group of organic-degenerative disorders of the basal ganglia. In opposite to this view psychoanalysts have pointed out since many years the psychogenesis of the syndrome. Our investigation starts with the descriptive analysis of three own cases. It will be shown how clinical facts present a complex situation, which allows the hypothesis, that somatic and psychogenetic factors coincide in the pathogenesis of occupational cramps. Finally a proposition is made how empirical evaluation of the hypothesis is possible.

Although its aetiopathogenesis is still unknown, writer's cramp is meanwhile regarded essentially an organically induced disorder. However, as shown by this interdisciplinary study, psychodynamic factors should not be neglected. Special attention should be given to the patients' experience of the syndrome and secondary psychoreactive processes.

Although the Stiff Man Syndrome has been traditionally viewed as a neurologic disorder, a number of recent articles have documented a pattern of familial, interpersonal, and intrapsychic stress which suggests that this disease may be, to a considerable degree, psychosomatic in origin. The present paper reviews several recent articles and focuses on a single case study. Although the medical diagnosis was earlier confirmed, an in-depth psychiatric evaluation and extensive psychological assessment showed many psychopathological concomitants associated with the severe muscle spasm and stiffness. A follow-up after about a year of group and individual psychotherapy showed that the symptoms were still in remission, and that the patient was functioning personally and occupationally on a significantly improved level.

The paper gives the results of a follow-up study of 58 patients after psychotherapeutic treatment as in-patients for writer's cramp. Where as immediately after discharge 74.1% of the patients felt an improvement in their condition, at the time of the follow-up study only 17.2% were demonstrably improved, with 37.9% subjectively feeling an improvement over their state before treatment as in-patients. These results suggest that the customary psychotherapeutic methods employed have less effect on the evidently multifactorial extrapyramidal-motor basic complaint but rather have the effect of improving the patient's ability to cope with this in daily life.