Talk:Psychosomatic medicine

Psychosomatic cf. Psychogenic

If anyone knows the difference between a psychosomatic illness and a psychogenic one, that would be a useful bit of information to throw into the article.

Just what I wanted to say ... and it has great importance. I believe this article and related articles about "psychosomatic" illness neeed to be placed into a proper linguistic and scientific/philosophical framework and currently are not.

OK HERE GOES >>>>> No one has responded at all regarding the material I have written below. I am going toplace it in the article as a BOLD piece of editing.

--Zigzagzen 09:45, 4 July 2007 (UTC)

I would like to see something along the lines of the following material added to the pages so that it is clear there is much debate about the reality of these "conditions". I would welcome other contributors thoughts on the material I have written below in this context. I have not edited the page as I realise the material here may be quite controversial.

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This article and the science behind it are controversial on two grounds. The first is an etymological error that has crept into medicine. The second is the failure of medical practitioners to be realistic about the current limitations of medicine itself.

The Etymological Error

Psychosomatic means "relating to mind and body". This article and related articles on Somatization disorder and Conversion disorder actually relate to an entirely different class of problems that better labelled "psychogenetic". Psychogenetic means "originating in the mind", from the latin psychicus - meaning "belonging to the soul" and genesis - meaning "origin or source".

The Infallible Doctor Error

Doctors sometimes like to explain the things they can not explain by blaming the mind of their patients. If doctors said "we do not understand this" they would be showing themselves as limited humans - like the rest of us. This is an ego-centric disorder inherent in the minds of psychiatric and medical doctors and not in the minds of the patients concerned.

Instead of admitting their own - and western medicines' - limitations they have invented a whole raft of "psychosomatic" problems and disorders that might not exist, but actually confirm the current limitations of medical science.

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--Zigzagzen 10:38, 20 June 2007 (UTC)

References?

The article says that "There were times when almost any illnesses suffered by women were ascribed to hysteria, while anything men suffered from was not, since it was believed men did not suffer from hysteria. This view has changed since World War I, when men started to return from the front with what was called 'shell-shock syndrome'," this information seems a little more erudite than common knowledge and should be cited. It isn't very credible otherwise. Muggwort17 14:47, 6 November 2005 (UTC)

The article had a small chart or box overlying the text at the top right of the viewed page. It spelled out two classifications for this subject and stated links to classification charts. Those were "ICD-10 code F-45" and "ICD-9 code 306.9". Neither of those links mentioned anything about "psychosomatic illness" either in heading nor in item and I intend to remove those links. First they are in the wrong place, overlaying the text which introduces the subject. Second, they are not germane, they do not directly pertain to the subject of what psychosomatic illness is nor how it manifests. Terryeo 03:30, 12 December 2005 (UTC)

This article looks like it could have some good potential. In reference to the ICD box, it would seem that they do point to the same thing, however that is an underlying problem. Somatoform_disorders, Somatization_disorder, and Psychosomatic illness are all refering to the same basic condition. Something should be done to either remove, merge or clean up the articles. Tom Foolery 17:29, 13 December 2005 (UTC)

"soma" means body. "psyche" means mind or perhaps spirit." Psychosomatic means "the interplay of body and psyche" Perhaps "somatization disorder" and "somatoform disorders" might mean the same thing but that is not clearly splled out by those words, therefore if those words are introduced, referenced and linked as part of the Psychosomatic Illness article don't you think some introduction of meanings would be needed? Terryeo 20:46, 13 December 2005 (UTC)

After some further reasearch it would seem the difference can be broken down to this:

• Psychosomatic Illness = Psychosomatic Disorder
• Psychosomatic Disorders = Somatoform Disorders, the difference is that medically speaking, the term "psychosomatic" has fallen out of favor. This mainly can be seen by classification of "Somatoform Disorders" in both ICD-10 and DMS-IV. They can pretty much be used interchangeably as somatoform disorders are psychosomatic (interplay of the body and psyche).
• Somatization Disorder, is a type of somatoform disorder, ICD defines it here, which should stay its own article. (duh)

So then where does this all lead? I think the easiest would be to turn Somatoform disorders into a redirect for psychosomatic illness, mainly because this article already has some good content, and Somatoform disorders is a one lined stub. With that out of the way, this article could be cleaned up, types of illnesses defined, etc, etc. =)

Tom Foolery 02:22, 14 December 2005 (UTC)

It is a difficult area to sort through, I think, because any mention of psycho- anything leads away from medical practice and to controversial psychiatry, eastern medicine, holostic healing and dianetics. Where does one turn for authority? Skin rashes might be psychosomatic or might be viruses treatable by medicine. Ulcers and other things too are recognized has having a psycho- component. Rather than attempt great specificity in an area modern medicine is uncertain of, might it be better to give a general outline along with possible areas to explore for treatment? Because some people might read wiki to find possible avenues of treatment. Terryeo 18:12, 17 December 2005 (UTC)

I thought it was horribly written, and as we help many people who suffered from psychosomatic disease, I cleaned it up some. But I lack my textbooks for authoratitive quotes and references. Soulwork 21:20, 31 December 2005 (UTC)

I too agree, the direction of the article should include links people can explore toward handling and informing themselves of treatments today. I'm not a medical doctor. But it is my limited understanding, there is no specific profession that treats psychosomatic illnesses, and so, no authority whom diagnoses such illnesses. It is on the fringe of medical doctors, on the fringe of almost everything. Yet some disiplines address it. My grandmother went to a Chinese medicine guy locally, he was helpful to her. Dianetics is the best shot, my opinion but this is one POV only. Terryeo 04:34, 1 January 2006 (UTC)

No, no, no... psychosomatic disorders are completly different from somatoform disorders. Psychosomatic disorders are physical illnesses that are caused in part by a psychological factor. Somatoform disorders are when there is nothing physically wrong with the patient. The reason psychosomatic is falling out of psychological grace is that doctors are realizing that more and more diseases are caused by psychological factors. For instance, stress lowers the immune systems ability to function, so a common cold has the potential to be psychosomatic. It may not be, but in many cases a cold is psychosomatic. Of course, the same holds true for blood pressure. When I'm less busy I'll try to update using an intro to psych book (all we really need for this sort of article). Werefrog 00:05, 28 November 2006 (UTC)

NO NON NON NO ..... see what I have written above .. you are discussing Pschogenetic/Psychogenic problems and using the Psychosomatic etymological error I have discussed.

At root here of all the psychological and philosophical discusions are two historical errors 1) Descartes error of separating mind and body into different universes and 2) Freud's error of changing his theory: he first said “my patients were sexually interfered with when they were children and show improved functioning when they talk about it”, but later said “my patients have really vivid imaginations and are kind of fu**ed up”. This was because the Vienniese Aristocracy who made up his clients just were not ready to deal with the demons of child abuse and the fact that it was rife in their society. If these guys had not made the errors they had psychology and medicine would not be in such a mess today over these issues.

--Zigzagzen 11:02, 20 June 2007 (UTC)

"O NON NON NO ..... see what I have written above .. you are discussing Pschogenetic/Psychogenic problems and using the Psychosomatic etymological error I have discussed." Here's the problem with that: this is the way psychologists use the word. It doesn't matter if it's an error in the etymology. We have to use the technical, scientific definition. You can put in a note saying that in the common vernacular use it differently. You can even mention the etymology. BUT the article has to be about the standard scientific definition.Werefrog 04:28, 13 October 2007 (UTC)

going to remove a nonesense paragraph

This paragraph: "Psychosomatic symptoms show that a human body can create physical symptoms that compensate for relationship deficiencies. (For example, hypnosis-induced allergic reactions indicate that a person's immune response can dramatically change during an intense relationship)." Makes a conclusion. It states that because symptoms manifest we can conclude the cause is "the human body has created physical symtoms." May I point out, this article is about psycho-somatic. A statement that says, "the human body injures itself" may be a perfectly fine, wonderful statement. But that statement is not cited, that statement is poorly worded and is difficult to glean meaning from and probably, that statement belongs deeper into the article under a subheading something like, "There are no psychosomantic illnesses, instead, the body hurts itself. So, I'm going to remove that portion to this page unless someone discusses and cites how "Body hurts itself" is germane to "psychosomatic". Terryeo 00:54, 14 January 2006 (UTC)

removed dianetics allegation

"They also claim to cure arthritis, radiation poisoning, cancer, [1] and, according to a 1995 brochure, "70 percent of Man's illnesses". [2]" is so completely untrue that it is laughable. To only quote a second party source which gives an opinion about what the source opinionates is laughable. I this case it is also untrue. Dianetics doesn't claim to cure physical ills. The Dianetics site takes particular care to be very sure they make no such claim or implication. The E-Meter court fiassco, years ago, made sure Dianetics makes no such public claims. Why not find a quote where they claim the moon is made of green cheese? heh !Terryeo 21:13, 8 February 2006 (UTC)

Prevelance?

I've see several quotes in other sites that claim the the NIH has established that nine out of ten fatal diseases has a psychosomatic component and also that the NIH has established that two thirds of all ilnesses have a psychosomatic influence. Does anyone know of a reliable reference for these claims? Renaissance Healer

Definition of soma

I've been trying to find a definition of soma beyond the general definition that "soma" means body given in the discussion thread. The Wikipedia article on Soma makes no reference to this meaning as far as I can find. My sense is that Soma is an expanded sense of the body that includes energy systems, chakras, auras, etc. Does anyone have any suggestions about this?

Scientology?

Should we really mention Scientology in this page? It isn't necessary, none of the methods scientology use have any basis in science (ironic, considering their name) and they are actually opposed to psychiatry.

Refining the definition

Is it psychosomatic if it's caused entirely by one's thinking, attitude, or emotions? Or is the psychological aspect just one factor?

A disorder that involves both mind and body is called a psychosomatic illness. In other words, the illness may be emotional or mental in origin but have physical symptoms. Psychosomatic illnesses are not imaginary. They are physical disorders in which both emotions and thought patterns are believed to play a central role, and usually develop when a person's disease-fighting ability is weakened due to stress. After a particularly stressful event, like the loss of a loved one, for example, an individual might develop high blood pressure shortly afterward or even have a heart attack. In another person, the same situation might lead to a peptic ulcer or a series of asthma attacks. A third individual, equally as grief-stricken, might not get sick at all. For a psychosomatic illness to occur, a person must first be vulnerable in a particular body system. [3]

The above quote implies that a physical disorder can be caused in part by emotions and thought patterns. --Wing Nut 19:42, 5 July 2006 (UTC)

I understand the term psychosomatic has historically been used to mean that, but is presently construed as to indicate conditions that present physiological and psychological manifestations. On the other hand, physiological conditions caused (or at least triggered) by psychoemotional factors are referred to as psychogenous. This doesn't appear to be the same as somatoform, for on the current Wikipedia definition that only means a condition "for which no adequate medical explanation has been found", i.e., a relevant organic disorder hasn't been isolated. On the current wikipedia ref, functional symptoms are described as having "no current visible organic basis, e.g. if they are a result of psychological or perceptual dysfunction", but other circumstances could concur. S

Anorexia and Bulemia

I don't believe that these should be categorized as psychosomatic. I think they are better categorized as neuroses, but I expect that the psychologists have more specific, somewhat different categories for them. The reason I don't think they are psychosomatic is that, as I understand it, psychosomatic illnesses create symptoms of real degenerative processes in the body, whereas anorexia and bulemia create actions by the individual against their own body. The psychosomatic process is covert and the anorexic / bulemic actions are overt. The a / b patient overtly witholds food or induces regurgitation. 68.164.88.178 09:55, 10 July 2006 (UTC)

German article on psychosomatic disturbances

It may not be very helpful, but I want to draw peoples' attention to the German article which I find excellent; in accordance with the state of the art of medical science and psychotherapy. It's also critical enough towards popular "pseudo"-psychosomatic beliefs and ideology.

Friedhelm, Germany, 30 August 2006

It is helpful, but it would be even more helpful if you could translate something from the de page. This page badly needs some attention. Leibniz 12:29, 31 August 2006 (UTC)

Yes, it' true - a translation would be good. But I'm sorry, my English is not good enough for that, especially as adequate "scientific" vocabulary is necessary, and medical/psychotherapeutical knowledge in English as well. Psychosomatics is a complex field, and it needs well-founded differentiation of proved knowledge/facts, plausible theory on the one hand and beliefs, claims, ideology etc. on the other. Including a historical overview of the many different concepts and their development, and what can still be maintained as valid enough.

Friedhelm, Germany, 2 September 2006

Your English looks fine to me, better than the average on Wikipedia. You don't have to be an expert, just cite verifiable sources. I would encourage you to get an account and make some edits. Leibniz 12:14, 2 September 2006 (UTC)

History

The history section needs some serious attention. No mention of Freud, Neurasthenia, Charcot, or of doctors' views on the causes of psychosomatic illness (the uterus in hysteria, reflexology, magnetism, etc.) and the legion of quacks who tried (and succeeded) in curing psychosomatic patients from the 18th century to the present day. I don't have time to do this right now, but if anyone else wants to make some contributions please go ahead.

For anyone interested in the history of psychosomatic illness I would strongly recommend Shorter's "From Paralysis to Fatigue: a History of Psychosomatic Illness in the Modern Era". In fact, that is the only good book on psychsomatic illness that seems to be out there.

--Sciencewatcher 22:55, 22 February 2007 (UTC)

A more modern work that references and builds on Shorter's work is Dr. John E. Sarno's recent book (2006), "The Divided Mind: The Epidemic of Mindbody Disorders" [4]. Dr. Sarno is a pioneer at diagnosing and successfully treating many modern ills as psychosomatic or psychogenic, particularly chronic back pain, tendonitis, RSI, and fibromyalgia, in his more than three decades at the Rusk Institute of Rehabilitation Medicine, where he is still practicing at age 83. He is also a Professor of Rehabilitation Medicine at the NYU School of Medicine, and the author of other books, including "Healing Back Pain: The Mind-body Connection," (1991) [5], and "The Mindbody Prescription: Healing the Body Healing the Pain" (1998)[6]. Ralphyde 00:39, 23 February 2007 (UTC)

Definition a bit loose

Actually the psychosomatic disorders may be bidirectional, not only imposed by the mind on the body but also physical processes producing mental disorders may classify as psychosomatic as well even if there is not a consensus about that. For example hormonal disorders may have rebouncing effects and become psychosomatic I.e. hormonal imbalance>depression>anorexia I will see if I find citations that are solid because most are contradictory Librarian2 16:49, 16 August 2007 (UTC)

This is a term that I've heard batted about in pop culture. On a medical level, this article may be a candidate for redirect to somatoform disorder. It invokes ICD codes, but those talk about somatoform, not psychosomatic illness. Antelan ^talk 19:37, 20 August 2007 (UTC)

What about redirecting or linking to PNI ? What do you think? Can you anyhow put a template of WP:MED ? I cannot find it Librarian2 20:06, 20 August 2007 (UTC)

I disagree with any redirecting of psychosomatic, as it has an important history tracing back to Freud and Jung, and there are many links to it (317) in Wikipedia. It is also coming back as the basis for mindbody medicine.

In the introduction to his new book (2006), The Divided Mind: The Epidemic of Mindbody Disorders,[7] Dr. John E. Sarno of the Howard A. Rusk Institute of Rehabilitation Medicine says: "First I want to clear up any confusion surrounding the word psychosomatic. You may think it refers to something vaguely fraudulent, such as imaginary diseases dreamed up by people for there own selfish or confused reasons. That's simply not true. But even medical practitioners, doctors who might be expected to have a more accurate understanding of the term, sometimes make the mistake of assuming it refers to how stress makes disease worse, or the stressful consequences of living with a disease. Those are legitimate concerns and have been addressed in the medical literature, but they are not psychosomatic. Psychosomatic medicine specifically refers to physical disorders of the mindbody, disorders that may appear to be purely physical, but which have their origin in unconscious emotions, a very different and extremely important medical matter. Note that we will use the terms psychosomatic and mindbody interchangeably throughout the book, so don't let it throw you."

"There are literally hundreds of disorders and illnesses that have been identified as purely psychosomatic or having a psychosomatic component. We will explore many of them in the pages that follow. They can range from mildly bothersome back pain all the way to cancer, depending on the power and importance of unconscious emotional phenomena. Psychosomatic illnesses seem to be an inescapable part of the human condition. Yet amazingly, in spite of the nearly universal prevalence of such disorders, the practice of psychosomatic medicine is almost totally unknown within today's medical community, and plays virtually no part in contemporary medical study and research. Nowadays, when physicians and many psychiatrists are confronted with a psychosomatic disorder, they do not recognize it for what it is and almost invariably treat the symptom."

Dr. Sarno has been practicing medicine at the Rusk Institute since 1965, and has become world renowned for his success at treating mindbody pain disorders from back pain to fibromyalgia to carpal tunnel syndrome. He has written four books on his diagnosis and treatment methods. Ralphyde 22:15, 20 August 2007 (UTC)

Sorry, I think I wasn't clear. I agree that psychosomatic illnesses are very real indeed, but it was my understanding that they are so closely related to somatoform disorders as to merit a merge. If others feel that's not the case, I'm fine with that. The Merck Manual, for example, equivocates on this matter.[8] However, the ICD codes on this article are for somatoform disorder. Are there thoughts on that? Antelan ^talk 23:24, 20 August 2007 (UTC)

The Merck Manual you referenced also distinguishes between the two as follows in the section on Psychosomatic disorders: "Unlike somatoform disorders, psychosomatic disorders do not fit into specific diagnostic categories, and they manifest in a variety of ways. Social and psychologic stress can also aggravate a wide variety of physical diseases, including diabetes mellitus, coronary artery disease, and asthma."

"Stress can cause physical symptoms even when no physical disease is present. For example, hives can be brought on entirely by a psychologic reaction. In some cases, physical symptoms result from the body's automatic response to emotional stress, as when heart rate and blood pressure increase in response to fear. In other cases, psychologic symptoms become physical symptoms in an unconscious attempt to divert attention away from a troublesome emotional issue." Ralphyde 01:54, 21 August 2007 (UTC)

Yes, but it equivocates. As you noted, it says that psychosomatic disorders are distinct from somatoform disorders. At the same time, the very first sentence says, Somatoform disorder is a relatively new term for what many people used to refer to as psychosomatic disorder. In this way, the Merck Manual takes both sides of the issue (equivocates). Because of this, I dropped my suggestion to merge the two articles, and I'm now wondering what you think about the status of the ICD codes. Thanks, Antelan ^talk 19:51, 21 August 2007 (UTC)

The ones listed look pretty good to me. There may be others which might also fit within the broad definition of psychosomatic. But I can't get excited about the codes. Ralphyde 22:31, 21 August 2007 (UTC)

Because they refer to somatoform disorder, which you are distinguishing from psychosomatic illness, I plan on removing the ICD codes. Antelan ^talk 23:59, 21 August 2007 (UTC)

No mention of (Georg) Groddeck?

I've heard of him described as the "father of psychosomatic medicine"... Critic9328 21:13, 14 October 2007 (UTC)

National Library of Medicine

Much of the 'History' section of this article appears to have been taken, almost word for word, from this web page from the NLM titled: Psychosomatic Medicine: "The Puzzling Leap". That website requests that "National Library of Medicine (NLM) be given appropriate acknowledgement" if the text is used elsewhere. — BillC ^talk 21:20, 28 October 2007 (UTC)

Add: and some of the intro has come verbatim from this book review. — BillC ^talk 21:26, 28 October 2007 (UTC)

What a crock!

Starting with this: "There is also a probable psychological influence in the development and outcome of conditions such as migraines." This is not only unproven but unaccepted by leading neurologists. While Wikipedia entries on physics and other hard sciences tend to be quite good, anything to do with psychiatry is a heap of conjecture and outright quackery. 68.58.2.232 (talk) 15:05, 6 February 2008 (UTC)