CLANDESTINE THOUGHTS AND GRAVES-DISEASE

We describe a 42-year-old man with Graves' disease who became thyrotox ic coincident with a major emotional trauma that was not disclosed unt il his third visit to the clinic. The possibility that distress denied might ignite Graves' disease via cross talk in the psychoimmunoendocr ine network is considered. We suggest that an empathic search for the stressor that activated the disease and the use of stress reduction te chniques in the long-term management of Graves' disease may be useful. If nothing else, the physician may benefit from hearing the story of the individual's illness rather than the history of a patient's diseas e.