Psychosomatics and the Future

It is important that a distinction be made between psychosomatic disorders
and three other conditions listed in the Diagnostic and Statistical Manual of
Mental Disorders: DSM-IV-TR (rev. 4th ed., 2000), which is the official classification
system for mental disorders published by the American Psychiatric
Association. Psychosomatic disorders, which are covered by the category
Psychological Factors Affecting Physical Conditions, are not themselves considered
mental disorders. While the psychological factors that cause the
physical illness are unhealthy or abnormal from a psychiatric or psychological
perspective, the psychosomatic disorder is a real, physical illness or condition
controlled by real, physical processes.
Somatoform disorders, on the other hand, are mental disorders which
manifest themselves through real or imagined physical symptoms for which
no physical cause exists. These symptoms are not intentionally produced by
the client. Conversion disorder is one of the somatoform disorders that
laypeople often confuse with psychosomatic disorders. Unlike the case with
psychosomatic disorders, there is no organic or physiological pathology that
would account for the presence of the physical symptoms displayed by the
person suffering from a conversion disorder. Hypochondriasis is the second
somatoform disorder that is often confusing for laypeople. The person suffering
from hypochondriasis fears or believes that he or she has the symptoms
of a serious disease, but the imagined “symptoms” are actually normal
sensations or body reactions which are misinterpreted as symptoms of disease.
Malingering is the third condition which is sometimes confused with psychosomatic
disorders. The person who is malingering is faking illness and is
reporting symptoms that either do not exist at all or are grossly exaggerated.
The malingering is motivated by external goals or incentives.
By eliminating many of the diseases that used to be epidemic, especially
those which killed people early in life, medical science has increased the average
life expectancy of Americans by about thirty years since the beginning
of the twentieth century. Eliminating the psychological factors that cause
psychosomatic disorders holds promise for another increase in average life
expectancy in the next few decades. Heart disease, cancer, and strokes are
the top three killer diseases in the United States, and each has a powerful
psychosomatic component. The reduction in human suffering and the economic
benefits that can be gained by controlling nonfatal psychosomatic
disorders are equally promising.
Cognitive and health psychologists have, particularly since the 1970’s,
tried to determine the degree to which cognitive psychotherapy interventions
can boost immune system functioning in cancer patients. They have
also used behavioral and cognitive therapy approaches to alter the attitudes
and behaviors of people who are prone to heart disease and strokes, with
considerable success. In the near future, they can be expected to focus their
efforts on two major fronts. The first will involve further attempts to identify
the psychological factors which might increase people’s propensity to develop
psychosomatic disorders. The second will involve continuing efforts
to develop and refine the therapeutic interventions intended to reduce the
damage done by psychosomatic disorders, and possibly to prevent them entirely.
Sources for Further Study
Chopra, Deepak. Creating Health. Reprint. Boston: Houghton Mifflin, 1991.
Chopra is a proponent of meditation, an approach that not all American
psychologists feel comfortable advocating. Nevertheless, this book is written
by a practicing physician for the layperson. He covers a wide variety of
psychosomatic disorders, suggests a variety of healthy habits, and presents
the viewpoint that “health is our natural state.”
Pert, Candace B. Molecules of Emotion. New York: Simon & Schuster, 1997.
This is a highly accessible book written in an engaging style with wit and
humor. Pert discusses her research on the scientific bases of mind-body
medicine and the difficulties in integrating these concepts into Western
medicine. The book contains appendices with a list of resources and
practitioners, an extensive glossary, and recommended readings.
Seligman, Martin E. P. Learned Optimism. New York: Alfred A. Knopf, 1991.
Chapter 2 provides an especially interesting account of how two young
graduate students can upset one of the most basic assumptions of a wellentrenched
viewpoint and promote the development of a new way of
looking at things. Chapter 10 describes how explanatory styles might affect
health and the mechanism by which this is thought to occur. A readable
book which examines an interesting concept.
Simonton, O. Carl, Stephanie Matthews-Simonton, and James L. Creighton.
Getting Well Again. New York: Bantam Books, 1980. Cancer researchers
and therapists examine the mind-body connection, effects of beliefs,
causes of cancer, effects of stress and personality, and effects of expectations
on the development and progress of cancer. They describe a holistic
approach to treatment, emphasizing relaxation and visual imagery, that
is reported to produce cancer survival rates that are twice the national
norm.
Taylor, Shelley E. Health Psychology. 5th ed. Boston: McGraw-Hill, 2003. A
moderately high-level college textbook that comprehensively covers the
general field of health psychology. As could be expected, many research
studies are presented, and not all of them corroborate one another. The
general reader should have no particular difficulty handling this material;
the writing is reader-friendly.
Wedding, Danny, ed. Behavior and Medicine. 3d ed. Seattle: Hogrefe&Huber,
2001. This large volume covers an extensive area of behavior and medicine,
which include stress and various behaviors which may affect physiological
health. The articles cover such behavioral issues as substance
abuse, stress management, pain, placebos, AIDS, cardiovascular risk, and
adherence to medical regimens. Other behavioral issues are covered
which relate to love and work, as well as developmental issues from infancy
to death, dying and grief. The book is readable and includes illustrations,
bibliographies, summaries, and study questions at the end of
each article.
John W. Nichols; updated by Martha Oehmke Loustaunau
See also: Cognitive Behavior Therapy; Cognitive Therapy; Emotions; Endocrine
System; Learned Helplessness; Stress-Related Diseases. 691