Type of psychology: Psychopathology
Fields of study: Cognitive processes; organic disorders; stress and illness
Psychosomatic disorders are physical disorders produced by psychological factors such as stress, mental states, or personality characteristics. A variety of psychological or psychotherapeutic interventions have been developed to alter the individual's ability to cope with stressful situations and to change the personality or behavior of the individ-
• behavior modification
• locus of control
• psychological factors affecting physical condition
• psychosomatic disorders
• Type A behavior pattern
The term "psychosomatic" was introduced by physician Flanders Dunbar in the early 1940's, shortly after Hans Selye presented the concept of "stress." Psychosomatic disorders are physical disorders which are caused by, or exacerbated by, psychological factors. These psychological factors fall into three major groups: stress resulting from encounters with the environment, personality characteristics, and psychological states. Psychosomatic disorders are different from two other conditions with which they are often confused. Psychosomatic disorders are real—that is, they are actual physical illnesses that have underlying psychological causes or that are made worse by psychological factors. In somatoform disorders (such as hypochondriasis), by contrast, there is no physiological cause; another condition, malingering, is the faking of an illness.
Psychosomatic disorders can affect any of the organ systems of the body. Certainly, not all physical disorders or illnesses are psychosomatic disorders; in many cases, an illness or physical disorder is caused entirely by biogenic factors. In many other cases, however, there is no question about the importance of psychogenic factors. The American College of Family Physicians has estimated that 90 percent of the workload of doctors is the result of psy-chogenic factors.
Many familiar and common psychosomatic disorders that can affect the body's various organ systems. Included among them are skin disorders, such as acne, hives, and rashes; musculoskeletal disorders, such as backaches, rheumatoid arthritis, and tension headaches; respiratory disorders, such as asthma and hiccups; and cardiovascular disorders, such as hypertension, heart attacks, strokes, and migraine headaches. Other disorders have also been related to psychological factors, including anemia, weakening of the immune system, ulcers, and constipation. Genitourinary disorders such as menstrual problems, vaginismus, male erectile disorder, and premature ejaculation are included among psychosomatic disorders, as are certain endocrine and neurological problems.
The relationship between the mind and the body has long been the subject of debate. Early societies saw a clear link between the two. Early Greek and Roman physicians believed that body fluids determined personality types and that people with certain personality types were prone to certain types of diseases. Beginning during the Renaissance, the dominant line of thought held that there was little or no connection between the mind and the body. Illness was seen as the result of organic, cellular pathology. Destruction of body tissue and invasion by "germs," rather than personality type, were seen as the causes of illness.
Sigmund Freud's work with patients suffering from conversion hysteria began to demonstrate both the importance of psychological factors in the production of physical symptoms of illness and the value of psychological therapy in changing the functioning of the body. Research conducted in the 1930's and 1940's suggested that personality factors play a role in the production of a variety of specific illnesses, including ulcers, hypertension, and asthma.
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