psychosomatic medicine By Inhere is still a lack of agreement about basic concepts in this field. The name 'tself is unfortunate, since it tends to perpetuate dualistic thinking of the "ghost ?n the machine" Suggested type. Tiechanisms to explain "the mysterious leap from mind to body" are controversial. In a sense, all diseases can be called
"psychosomatic", but this does little to Advance knowledge. Another way is to Postulate a psychosomatic approach or Method of study, which can be applied to any patient; this is sound clinical sense, and has been used by all thoughtful Physicians for centuries. For a more thorough study, the field Heeds to be limited, and rather than draw tip an arbitrary list of so-called psychosomatic diseases, it is better to investigate conditions which have a definite Physical pathology, but in which emotional factors are thought to be important. This would eliminate the neuroses, as well 5s psychological disorders arising directly from physical causes, such as delirium. But the danger of an either/or viewPoint must also be avoided, since the condition is not either organic or functional in so many cases, but both. In recent years, there have been great advances in understanding the anatomical basis of emotional expression, as well as the physiological and biochemical aspects. Methods of research have also improved.
F. E.
Kenyon
Psychoanalysts have made important contributions, but their earlier work tended to be naive and anecdotal, often relying on single case studies. There is now a greater awareness of the importance of using the most refined techniques available, whether psychological or statistical. Single case histories are still being published, a recent example being Ascent from Chaos by P. E. Sifneos (Harvard University Press, 27s), which is entirely devoted to one patient with ulcerative colitis. Exhaustive details are given about his life and illness, as well as his treatment by an "anaclitic" method, in which the patient regresses to complete dependence on the therapist. Whilst providing an interesting story, it adds nothing fundamental to our understanding of this distressing and sometimes fatal condition? not even to the crucial problem of why this particular man developed this particular condition.
Practically every branch of medicine has been written about in a special monograph devoted to the psychosomatic aspects. A recent addition is an American study of Neurology (Psychosomatic Neurology by H. A. Teitelbaum, Grune & Stratton, $13.75). Whilst admiring the author's industry, and being grateful for the many references (although not always sufficiently up-to-date), the whole is an undigested and uncritical catalogue of all
267
possible neurological conditions which could have associated emotional symptoms. This exemplifies the much wider and looser use of the term "psychosomatic". Superficially comprehensive, this book contains some surprising omissions?e.g., no mention of euphoria in multiple sclerosis. In 1955, the Society for Psychosomatic Research was founded in London, and their conference reports have been published periodically. Reports of the Conferences held in 1960, 1961 and 1962 have now somewhat belatedly appeared in print. The first is Psychosomatic Disorders in Adolescents and Young Adults, edited by J.
Hambling and P. Hopkins (Pergamon Press, 60s.), and covers a very wide field. General topics are fitness for marriage, concepts of mental health, psychosexual development, disorders of menstruation and pregnancy. Particular problems seen in industry and at university are discussed, as well as specific conditions such as acne, tuberculosis, epilepsy and diabetes. Many of the contributions are psychoanalytically orientated.
Some of the more fundamental aspect tackled in The Role of Psychosotnal'c Disorder in Adult Life, edited by J- 0' Wisdom and H. Wolff (Pergamon Press* 60s.). As more questions are raised thafl
are
answered, the overall result is disappoint' ing. Recent advances in neuro-anatomy and physiology are expounded, along with problems of personality involvement and shifts of one type of illness to another i? the same person. In spite of earlier attempts at differentiating psychosomatic and
psychoneurotic syndromes,
a
good
deal of space is devoted to discussing the latter.
volume, Principles of Treat' of Psychosomatic Disorders, edited Hopkins and H. Wolff (Pergamon Press, 35s.), covers very well-worn paths* and at times it is difficult to realise that this was a psychosomatic and not a general psychiatric conference. Some topics discussed are drug therapy, placebo reactions, behaviour therapy, hypnosis* psychotherapy and environmental modi' fications. As with the others, little original research is reported. The third
ment by P.
"psychosomatic", but this does little to Advance knowledge. Another way is to Postulate a psychosomatic approach or Method of study, which can be applied to any patient; this is sound clinical sense, and has been used by all thoughtful Physicians for centuries. For a more thorough study, the field Heeds to be limited, and rather than draw tip an arbitrary list of so-called psychosomatic diseases, it is better to investigate conditions which have a definite Physical pathology, but in which emotional factors are thought to be important. This would eliminate the neuroses, as well 5s psychological disorders arising directly from physical causes, such as delirium. But the danger of an either/or viewPoint must also be avoided, since the condition is not either organic or functional in so many cases, but both. In recent years, there have been great advances in understanding the anatomical basis of emotional expression, as well as the physiological and biochemical aspects. Methods of research have also improved.
F. E.
Kenyon
Psychoanalysts have made important contributions, but their earlier work tended to be naive and anecdotal, often relying on single case studies. There is now a greater awareness of the importance of using the most refined techniques available, whether psychological or statistical. Single case histories are still being published, a recent example being Ascent from Chaos by P. E. Sifneos (Harvard University Press, 27s), which is entirely devoted to one patient with ulcerative colitis. Exhaustive details are given about his life and illness, as well as his treatment by an "anaclitic" method, in which the patient regresses to complete dependence on the therapist. Whilst providing an interesting story, it adds nothing fundamental to our understanding of this distressing and sometimes fatal condition? not even to the crucial problem of why this particular man developed this particular condition.
Practically every branch of medicine has been written about in a special monograph devoted to the psychosomatic aspects. A recent addition is an American study of Neurology (Psychosomatic Neurology by H. A. Teitelbaum, Grune & Stratton, $13.75). Whilst admiring the author's industry, and being grateful for the many references (although not always sufficiently up-to-date), the whole is an undigested and uncritical catalogue of all
267
possible neurological conditions which could have associated emotional symptoms. This exemplifies the much wider and looser use of the term "psychosomatic". Superficially comprehensive, this book contains some surprising omissions?e.g., no mention of euphoria in multiple sclerosis. In 1955, the Society for Psychosomatic Research was founded in London, and their conference reports have been published periodically. Reports of the Conferences held in 1960, 1961 and 1962 have now somewhat belatedly appeared in print. The first is Psychosomatic Disorders in Adolescents and Young Adults, edited by J.
Hambling and P. Hopkins (Pergamon Press, 60s.), and covers a very wide field. General topics are fitness for marriage, concepts of mental health, psychosexual development, disorders of menstruation and pregnancy. Particular problems seen in industry and at university are discussed, as well as specific conditions such as acne, tuberculosis, epilepsy and diabetes. Many of the contributions are psychoanalytically orientated.
Some of the more fundamental aspect tackled in The Role of Psychosotnal'c Disorder in Adult Life, edited by J- 0' Wisdom and H. Wolff (Pergamon Press* 60s.). As more questions are raised thafl
are
answered, the overall result is disappoint' ing. Recent advances in neuro-anatomy and physiology are expounded, along with problems of personality involvement and shifts of one type of illness to another i? the same person. In spite of earlier attempts at differentiating psychosomatic and
psychoneurotic syndromes,
a
good
deal of space is devoted to discussing the latter.
volume, Principles of Treat' of Psychosomatic Disorders, edited Hopkins and H. Wolff (Pergamon Press, 35s.), covers very well-worn paths* and at times it is difficult to realise that this was a psychosomatic and not a general psychiatric conference. Some topics discussed are drug therapy, placebo reactions, behaviour therapy, hypnosis* psychotherapy and environmental modi' fications. As with the others, little original research is reported. The third
ment by P.
