Psychosomatic illness
Encyclopedia
Psychosomatic medicine is an interdisciplinary medical field studying the relationships of social, psychological, and behavioral factors on bodily processes and well-being in humans and animals. The influence that the mind has over physical processes — including the manifestations of physical disabilities that are based on intellectual infirmities, rather than actual injuries or physical limitations — is manifested in treatment by phrases such as the power of suggestion, the use of "positive thinking
" and concepts like "mind over matter
".
The academic forebear of the modern field of behavioral medicine
and a part of the practice of consultation-liaison psychiatry, psychosomatic medicine integrates interdisciplinary evaluation and management involving diverse specialties including psychiatry
, psychology
, neurology
, surgery
, allergy
, dermatology
and psychoneuroimmunology
. Clinical situations where mental processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence.
the Persian Muslim psychologist
-physicians
Ahmed ibn Sahl al-Balkhi
(d. 934) and Haly Abbas
(d. 994) developed an early understanding of illness that was due to the interaction of the mind and the body. They realized how a patient's physiology
and psychology
can have an effect on one another. They found correlations between patients who were physically and mentally healthy
and between those who were physically and mentally ill.
Franz Alexander
led in the beginnings of the 20th century, the movement looking for the dynamic interrelation between mind and body. Sigmund Freud
pursued a deep interest in psychosomatic illnesses following his correspondence with Georg Groddeck
who was, at the time, researching the possibility of treating physical disorders through psychological processes.
Since the 1970s, due to the work of Thure von Uexküll
and his colleagues in Germany and elsewhere, biosemiotic
theory has been used as a theoretical basis for psychosomatic medicine. Particularly, the umwelt
concept and the theory of organism by Jakob von Uexküll
has been found useful as an approach to describe psychosomatic phenomena.
es in everyday life. Psychiatry has found it difficult until relatively recently to distinguish somatoform disorders, disorders in which mental factors are the sole cause of a physical illness, from psychosomatic disorders, disorders in which mental factors play a significant role in the development, expression, or resolution of a physical illness.
For instance, while peptic ulcer
was once thought of as being purely caused by stress, later research revealed that Helicobacter pylori
caused 80% of ulcers. However 4 out of 5 people colonised with Helicobacter pylori
do not develop ulcers, and an expert panel convened by the Academy of Behavioral Medicine Research concluded that ulcers are not merely an infectious disease and that mental factors do play a significant role. One likelihood is that stress diverts energy away from the immune system, thereby stress promotes Helicobacter pylori
infection in the body.
It is still difficult to classify some disorders as purely physical, mixed psychosomatic, or purely somatoform. One example is Irritable Bowel Syndrome
(IBS) that was considered formerly as having purely mental causes, while subsequent research showed significant differences in the behaviour of the gut in IBS patients. On the other hand, there are no actual structural changes in IBS patients and research shows that stress and emotions are still significant factors in causing IBS.
However, while it is necessary to identify if an illness has a physical basis, it is recognized more and more that the effort to identify disorders as purely physical or mixed psychosomatic is increasingly obsolete as almost all physical illness have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment, and resolution. Addressing such factors is the remit of the applied field of behavioral medicine
. In modern society, psychosomatic aspects of illness are often attributed to stress
making the remediation of stress one important factor in the development, treatment, and prevention of psychosomatic illness.
s. Such illness is classified as neurotic, stress-related and somatoform disorders by the World Health Organization
in the International Statistical Classification of Diseases and Related Health Problems. The field of psychosomatic medicine fell into disrepute clinically due to this incorrect use of this term, which was largely due to the influence of psychoanalytic theory on psychiatric physicians and the inaccurate application by non-specialists in the first part of the 20th century who considered this form of illness to be akin to malingering
, thereby further harming the sufferer. For this reason, among others, the field of Behavioral Medicine
has taken over much of the remit of Psychosomatic Medicine in practice and there exist large areas of overlap in the scientific research.
are used to treat psychosomatic disorders.
Positive Thinking
Positive Thinking... or Positive Thinking may refer to one of two songs:*Positive Thinking *Positive Thinking...
" and concepts like "mind over matter
Mind over matter
Mind over matter is a phrase popularized during the 1960s and 1970s that was originally used in reference to paranormal phenomena, especially psychokinesis. However, it has also been used in reference to mind-centric spiritual and philosophic doctrines such as responsibility assumption. It is the...
".
The academic forebear of the modern field of behavioral medicine
Behavioral medicine
Behavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness...
and a part of the practice of consultation-liaison psychiatry, psychosomatic medicine integrates interdisciplinary evaluation and management involving diverse specialties including psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
, psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
, neurology
Neurology
Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
, surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, allergy
Allergy
An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...
, dermatology
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....
and psychoneuroimmunology
Psychoneuroimmunology
Psychoneuroimmunology is the study of the interaction between psychological processes and the nervous and immune systems of the human body...
. Clinical situations where mental processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine has competence.
History of psychosomatics
In the medieval Islamic worldIslamic Golden Age
During the Islamic Golden Age philosophers, scientists and engineers of the Islamic world contributed enormously to technology and culture, both by preserving earlier traditions and by adding their own inventions and innovations...
the Persian Muslim psychologist
Islamic psychology
Islamic psychology translates the term ʿIlm al-Nafs the science of the Nafs and refers to the medical and philosophical study of the psyche from an Islamic perspective...
-physicians
Islamic medicine
In the history of medicine, Islamic medicine, Arabic medicine or Arabian medicine refers to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization....
Ahmed ibn Sahl al-Balkhi
Ahmed ibn Sahl al-Balkhi
Abu Zayd Ahmed ibn Sahl Balkhi was a Persian Muslim polymath: a geographer, mathematician, physician, psychologist and scientist. Born in 850 CE in Shamistiyan, in the Persian province of Balkh, Khorasan , he was a disciple of al-Kindi...
(d. 934) and Haly Abbas
Ali ibn Abbas al-Majusi
Ali ibn al-'Abbas al-Majusi , also known as Masoudi, or Latinized as Haly Abbas, was a Persian physician and psychologist most famous for the Kitab al-Maliki or Complete Book of the Medical Art, his textbook on medicine and psychology.-Biography:He was born in Ahvaz, southwestern Persia, and...
(d. 994) developed an early understanding of illness that was due to the interaction of the mind and the body. They realized how a patient's physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
and psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...
can have an effect on one another. They found correlations between patients who were physically and mentally healthy
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
and between those who were physically and mentally ill.
Franz Alexander
Franz Alexander
Franz Gabriel Alexander was a Hungarian-American psychoanalyst and physician, who is considered one of the founders of psychosomatic medicine and psychoanalytic criminology.- Life :...
led in the beginnings of the 20th century, the movement looking for the dynamic interrelation between mind and body. Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...
pursued a deep interest in psychosomatic illnesses following his correspondence with Georg Groddeck
Georg Groddeck
Georg Groddeck was a physician and writer regarded as a pioneer of psychosomatic medicine.-Method:...
who was, at the time, researching the possibility of treating physical disorders through psychological processes.
Since the 1970s, due to the work of Thure von Uexküll
Thure von Uexküll
Thure von Uexküll was a German scholar of psychosomatic medicine and biosemiotics. He has developed the approach of his father, Jakob von Uexküll, in the study of living systems and applied it in medicine.-Life:1955-1965: Director of the Medical Outpatient Department at the University of...
and his colleagues in Germany and elsewhere, biosemiotic
Biosemiotics
Biosemiotics is a growing field that studies the production, action and interpretation of signs in the biological realm...
theory has been used as a theoretical basis for psychosomatic medicine. Particularly, the umwelt
Umwelt
According to Jakob von Uexküll and Thomas A. Sebeok, umwelt is the "biological foundations that lie at the very epicenter of the study of both communication and signification in the human [and non-human] animal." The term is usually translated as "self-centered world"...
concept and the theory of organism by Jakob von Uexküll
Jakob von Uexküll
Jakob Johann von Uexküll was a Estonian biologist who worked in the fields of muscular physiology, animal behaviour studies, and the cybernetics of life. However, his most notable contribution is the notion of umwelt, used by semiotician Thomas Sebeok...
has been found useful as an approach to describe psychosomatic phenomena.
Psychosomatic disorders
Some physical diseases are believed to have a mental component derived from the stresses and strains of everyday living. This is the case, for example, of lower back pain and high blood pressure, which appear to be partly related to stressStress (biology)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...
es in everyday life. Psychiatry has found it difficult until relatively recently to distinguish somatoform disorders, disorders in which mental factors are the sole cause of a physical illness, from psychosomatic disorders, disorders in which mental factors play a significant role in the development, expression, or resolution of a physical illness.
For instance, while peptic ulcer
Peptic ulcer
A peptic ulcer, also known as PUD or peptic ulcer disease, is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm...
was once thought of as being purely caused by stress, later research revealed that Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...
caused 80% of ulcers. However 4 out of 5 people colonised with Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...
do not develop ulcers, and an expert panel convened by the Academy of Behavioral Medicine Research concluded that ulcers are not merely an infectious disease and that mental factors do play a significant role. One likelihood is that stress diverts energy away from the immune system, thereby stress promotes Helicobacter pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...
infection in the body.
It is still difficult to classify some disorders as purely physical, mixed psychosomatic, or purely somatoform. One example is Irritable Bowel Syndrome
Irritable bowel syndrome
Irritable bowel syndrome is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements...
(IBS) that was considered formerly as having purely mental causes, while subsequent research showed significant differences in the behaviour of the gut in IBS patients. On the other hand, there are no actual structural changes in IBS patients and research shows that stress and emotions are still significant factors in causing IBS.
However, while it is necessary to identify if an illness has a physical basis, it is recognized more and more that the effort to identify disorders as purely physical or mixed psychosomatic is increasingly obsolete as almost all physical illness have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment, and resolution. Addressing such factors is the remit of the applied field of behavioral medicine
Behavioral medicine
Behavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness...
. In modern society, psychosomatic aspects of illness are often attributed to stress
Stress (medicine)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...
making the remediation of stress one important factor in the development, treatment, and prevention of psychosomatic illness.
Connotations of the term "psychosomatic illness"
Psychosomatic medicine is not to be confused with the demotic and scientifically incorrect use of the phrase "psychosomatic illness" to apply to illnesses that are now called somatoform disorderSomatoform disorder
In psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder . The symptoms that...
s. Such illness is classified as neurotic, stress-related and somatoform disorders by the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
in the International Statistical Classification of Diseases and Related Health Problems. The field of psychosomatic medicine fell into disrepute clinically due to this incorrect use of this term, which was largely due to the influence of psychoanalytic theory on psychiatric physicians and the inaccurate application by non-specialists in the first part of the 20th century who considered this form of illness to be akin to malingering
Malingering
Malingering is a medical term that refers to fabricating or exaggerating the symptoms of mental or physical disorders for a variety of "secondary gain" motives, which may include financial compensation ; avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences;...
, thereby further harming the sufferer. For this reason, among others, the field of Behavioral Medicine
Behavioral medicine
Behavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness...
has taken over much of the remit of Psychosomatic Medicine in practice and there exist large areas of overlap in the scientific research.
Treatment
Psychosomatic medicine is considered a subspecialty of the fields of psychiatry and neurology. Medical treatments and psychotherapyPsychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
are used to treat psychosomatic disorders.
See also
- Behavioral MedicineBehavioral medicineBehavioral medicine is an interdisciplinary field of medicine concerned with the development and integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness...
- Conversion disorderConversion disorderConversion disorder is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fits without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric...
- Healing Words: Poetry and MedicineHealing Words: Poetry and MedicineHealing Words: Poetry and Medicine is a sixty-minute documentary filmed in 2008 primarily at Shands at the University of Florida. The production portrays individuals in personal quest to recover psychologically and physically from illnesses that have dramatically changed their lives...
(documentary film) - Placebo EffectPlacebo effectPlacebo effect may refer to:* Placebo effect, the tendency of any medication or treatment, even an inert or ineffective one, to exhibit results simply because the recipient believes that it will work...
- PsychoneuroimmunologyPsychoneuroimmunologyPsychoneuroimmunology is the study of the interaction between psychological processes and the nervous and immune systems of the human body...
- Psychosomatic Medicine (the journal)
- Somatoform disorderSomatoform disorderIn psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder . The symptoms that...
- SomatopsychicSomatopsychicSomatopsychic is a medical term for the effects of the body on the mind. Somatopsychic is used to describe a body-mind relationship, as does psychosomatic. Psychosomatic, however, refers to the mind's effect on the body.-External links:**...
External links
- Mind-Body Medicine: An Overview, US National Institutes of Health, Center for Complementary and Alternative Medicine
- NIH
- American Psychosomatic Society
- Psychosomatic Medicine, journal of the American Psychosomatic Society