Modern medicine classfieis patients into two types. On the one hand, there are people with so-called functional illnesses, where symptoms such as lack of appetite, vomiting, diarrhoea, cramps, muscle aches or an excessively strong heartbeat (tachycardia) cannot be attributed to a particular organic cause. On the other hand, there are those who are organically ill and suffer from so called somatic afflictions, such as tumours, diabetes, cancer or diseases of the heart or circulatory system, which are caused by pathological processes in one or several of the body’s vital organs.

For decades, doctors considered functional illnesses to be psychosomatic that is, made worse by emotional or psychological factors, such as stress. But today, patients can consult a specialist in psychosomatic medicine, a relatively new field in which medical doctors pursue an integrated or holistic, approach to healing the body’s illness.
The psychosomatic method

The basis of psychosomatics lies in the union of body and soul. The term is derived from the Greek words psukhe (psyche or soul) and soma (body), and designates that branch of the human sciences which deals with the relations between mental and physical processes in physically ill people.

First and foremost, pyschosomatics is based on a holistic perspective, in which the physician considers the overall picture of a patient and not nust his or her specific compliant. In spite of or perhaps even because of the high level of specialisation in modern medicine, there is rarely enough time for a doctor to consider a patient’s complete physical and psychological state. If she or he consults a doctor with a physical ailment, specialists will examine different organs, and try to explain the symptoms in terms of the pathological process at work in them.

A specialist in psychosomatics is a medical doctor who may also have training in psycho- analysis. He or she attempts to detect processes active in the patient’s subconscious mind and to assess their effect on the underlying causes of the disease. While this might diminish the role of the family doctor, this new approach to healing aims to healp the patient by uncovering the underlying reasons for his or her illness.

The subconscious mind plays a role in all illnesses, and the way it manifests itself leads to both physical and psychic disturbances. When a flu epidemic strikes, for sample, the virus never affects everyone. Each individual reacts differently to a specific virus, and this reaction is governed by his or her level or resistance, or immunity. Resistance to the virus, in turn, can vary depending on the psychic state of the patient.

Our early sensory experiences, whether it is seeing a parent or tasting a new food, are received through our five senses, often in connection with physical contact with our mother, and these experiences begin to allow us to formulate thoughts. The individual gradually learns to associate each of the pictures in his or her environment with a particular word. For example, teddy bear, thumb mother’s hands or food increasingly take their place in this repertoire of word representations. These take on symbolic meanings and enter a circle of images: words and memories that form the foundation of mental development.

Normally, when speaking about his or her own life, and especially about a serious illness or a traumatic memory, a person will usually try to awaken emotions, pictorial associations and possibly even similar memories for the listener. This allows two people to communicate; in this way, they are able to share a common imaginary world.

People suffering from socalled operative thinking display another pattern of behaviour. Their choice of words and tone of voice is impersonal, formulaic and verges on the mechanical. They are unable to express their feelings, and their fantasy world seems poorly developed which also expresses itself in dull or banal dreams. If they are asked to describe their illness, they reel off a report with no tme frame, presenting it in an unemotional and almost apathetic manner, without any feelings, complaints or fear.

Normally, people suffering from great mental anguish will usually say that this condition set in gradually after a traumatic personal experience, such as loss of a loved one, grief, separation or failure. Their anguish, known as reactive depression, represents an answer to a deep psychic shock. Since they have been deprived of a loved one or a positive self-image, these people react by going into mental suffering. This suffering is accompanied by a weakening of the body’s ability to overcome illness. Other symptoms of reactive depression are fatigue, sleep distrurbances or loss of appetite. Feelings of guilt may also come to the surface. When a loved one dies, a person will sometimes reproach him or herself for having treated the deceased badly. Normally, these feelings subside with the passage of time.

A fatal claim
The third key word in this field is the ego-ideal. This is a force that strongly affects an individual’s character and behaviour and is connected to the excessive demands which the patient places on him or herself. Such a person often acts according to the ‘all or nothing’ principle, and experiences any external problem or affiction as a serious blow to his or her narcissistic self-iage. If stricken by a serious illness, the patient has the ability to deny the seriousness of the situation and asks not to be pitied. He or she pretends to be healthy and remains strangely calm, while friends and relatives are filled with anxiety as a result of the illness and their concern for their loved one. In reality, such a patient has composed an ideal image of him or herself: an extremely limiting, even paralysing ego-ideal, which may salvage his or her pride, but can lead to death.

Psychosomatic treatment
When a patient goes to a see a specialist in psychosomatics, he or she usually does so on the advice of their family doctor. The first thing the specialist tries to find out is the position that the illness occupies in the patient’s mental balance. A severe flu when the atmosphere in the office becomes unearable; stomach pains that confine a child to bed the day before shcool starts: these combinations could explain the onset of illness. In such cases, it is best to treat the illness as real until the mind can take over an dsolve the conflict in the right way. So the specialist in psychosomatic medicine tries to ensure that both the body and the mind are cared for.

The so called clinical interview plays an important role in psychosomatic treatment. The clinical interview is a useful way to obtain information about the patient’s qualities, conflicts and personal situation. Questionnaries are frequently used to obtain objective measurements of certain aspects of a person’s personality.

Once the initial symptoms have been dealt with, the patient can be helped by psychotherapy in the form of weekly therapy sessions. The therapist offers support and listens carefully in order to uncover the source of conflicts and understand the patient’s behavious and thoughts. By encouraging the patients to speak openly about his or her feelings and ideas and by showing interest in his or her dreams, the individual is encouraged to understand their own thought processes by following the explanations given by the therapist. The therapist seeks to improve the patient’s mental balance, theraby protecting him or her from future physical affictions.