The psychosomatic medicine is a science of health that encompasses the relationship and clinical application between the mind (Psyche) and body (soma). It is based on the concept of the psychosomatic unit, that is, it postulates that biological and psychological processes are closely interrelated aspects of their function..
In this way, the conception of psychosomatic medicine is different from that presented by the traditional biomedical model, which analyzes diseases in human beings as the result of intrinsic problems of the individual, as well as the reaction to chemical substances and microorganisms. (virus or bacteria).
From these foundations, the notion of "psychosomatic illness" arose. This is defined as one in which psychological factors affect the onset or development of any organic or functional damage. These types of diseases are closely related to internal and general medicine.
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The idea that certain physical ailments are related to some vital events of the human being is very old.
For example, during the 19th century, scientists realized that several disease outbreaks arose during wars as a consequence of the emotional state of societies..
This phenomenon prompted the development of philosophical conjectures about the holistic nature of the human being.
The word "psychosomatic" was first coined by the psychoanalyst Felix Deutsch in 1922 and comes from the union of the words Psyche -mind- and soma -Body-.
As for the term "holistic", it consists of a philosophical adjective that considers something (be it a subject or object) as a whole. For this reason, when affirming that psychosomatic medicine is holistic, reference is made to the fact that this discipline considers man as a whole, where the mind and the body are closely related.
Later, the observations made during World War II were also determining factors in the development of psychosomatic medicine. These were carried out by United States military doctors, who observed how war trauma led to physical and mental disorders in soldiers..
Thanks to these theories, psychosomatic orientation in medicine became more important. In fact, a popular magazine on the subject and a national association emerged in the United States in the 1930s. Later, psychosomatic societies were founded in many countries, promulgating the creation of international meetings.
As observations and psychosomatic studies increased, this discipline began to arouse the interest of great intellectuals, as was the case of Sigmund Freud (1856-1939) and his followers..
This was a great boost for psychosomatic medicine, since it allowed the emergence of the theory that proposes that many medical disorders are mainly psychogenic..
However, the lack of scientific rigor in many studies, together with the absence of control over observer bias and the inadequate selection of the studied populations, put the research carried out in this field into question..
Another factor that weakened these investigations was the advance in the field of drugs and antibiotics. However, these elements prompted the restructuring of the investigations, becoming methodologically stricter and strengthening the scientific base and the quality of the observations..
Psychosomatic medicine studies the diseases that occur in people as a consequence of their relationships with an environment that is informative, social and cultural, as well as biophysical-chemical. In turn, this science indicates that people are not simply biological organisms, but sensitive individuals with emotions, thoughts, feelings and relationships..
According to a consensus statement issued by the European Association of Psychosomatic Medicine and the Academy of Psychosomatic Medicine, this discipline is part of consultation and liaison psychiatry, dedicated to the treatment and diagnosis of patients with recurrent physical and psychiatric illnesses..
However, other authors argue that psychosomatic medicine is not a synonym for consultation-liaison psychiatry and that it should be considered as a comprehensive interdisciplinary framework, with the aim of evaluating the psychological factors that affect individual vulnerability and the outcome of any kind sickness.
Despite these two approaches, it is necessary to point out that psychosomatic medicine does not provide theories about the nature of the underlying processes. It actually provides a holistic perspective to interpret them. It draws on data, theory and techniques from all other relevant fields, integrating them in unique ways.
Due to its holistic nature, psychosomatic medicine uses several theoretical models and their variants.
In this way, it suggests the possibility that several of these models may be operating simultaneously in a particular case, in addition to the multiple stimulus-response relationships that make up human function. Among the models used by psychosomatic medicine are:
This model rejects causality in the relationship. Therefore, he postulates that both the psychological and physical findings are the product of another preceding factor. That is, one stimulus causes the psychological findings while another produces the physical effects..
This model postulates that the relationship stems entirely from the effects of somatic processes in the mind. This is the traditional biomedical view, which sees all diseases as "physical" in nature and origin..
It states that psychological responses to external events cause somatic changes. More often, stress or strong emotions are invoked as intervention mechanisms.
This is a combination of the last two models, allowing for causality in both directions and feedback variations from each..
The application of psychosomatic medicine to patient care is primarily based on its basic concepts. Because each patient is unique, it is necessary to identify the specific problems of that individual to provide appropriate care.
Knowledge for proper diagnosis and treatment by the specialist is acquired in the course of professional education, always taking into account the holistic nature of psychosomatic medicine.
Similarly, the specialist must have sufficient knowledge of psychology and social sciences to identify the relationships between life experiences and physical symptoms. This understanding on the part of the expert allows him to select the biological therapies suitable for a particular individual..
Regarding the psychological side, the most useful and tolerable range of emotional liberation for the patient must be quantified and facilitated, as well as the level of understanding to look for the relevant psychosomatic correlations.
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