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Published Online:https://doi.org/10.1176/ajp.112.1.55

1. A case of chronic ulcerative colitis treated by inducing active patient collaboration in therapy with an internist and psychiatrist is reported.

2. Advantages and disadvantages of the psychotherapeutic use of ACTH and cortisone are considered.

3. ACTH and cortisone are discussed as valuable adjuncts to the psychotherapy of ulcerative colitis.

4. The philosophy of creating a collaborative therapist out of a chronically ill, masochistically-dependent individual by presenting the patient with personal control of ACTH as a "crutch" or tool, rather than an unrealistic panacea—we feel bears with it an explicit invitation to independent action and health. Such an approach may be applicable to other chronic psychosomatic diseases.

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