What is Psychosomatic Medicine?
Psychosomatic Medicine is a style of approach in the practice of medicine that takes into account the biological (somatic or organic), psychological and social factors of the patient in the genesis, diagnosis and treatment of his or her illness.
This orientation is opposed to the tendency towards super-specialization in modern medicine, representing an attitude that insists on considering the patient as a whole, attending not only to purely biological data but also to his or her social circumstances and psychological states.
Psychosomatic medicine is present in all human illness. The most effective drug in their treatment is the physician himself, if he takes charge of the patient’s biography and wishes for healing, involves him in the therapy and, sometimes, achieves acceptance of his illness when it has a chronic course.
What is a psychosomatic disorder?
What we could call psychosomatic disorders correspond to clinical pictures of different specialties, medical and surgical, in which, in addition to the purely biological components of the disease, play a very important role social and / or psychic, which can cause and maintain it. These other aspects constitute the object of Psychosomatic Medicine. These are the pathologies that require an integral treatment of the person, and not only the merely somatic one.
Among the pathologies that have a greater psychosomatic burden are: depression, addictions, headaches, some rheumatological and neurological diseases, as well as anxiety disorders.
Many organic diseases also have a psychosomatic facet: anemias, vitamin deficiencies, hormonal alterations and chronic infections caused by rare microorganisms. Also included are addictions to toxic substances that generate dependence (alcohol, tobacco, drugs).
Finally, there are some psychiatric disorders, such as conversion disorders (formerly called “hysteria”) and somatoform disorders (somatizations of psychic illnesses) that present clinically with manifestations characteristic of medical pathology, requiring a certain specialization for their early detection, differential diagnosis and treatment.
What are the causes of psychosomatic illnesses?
Psychosomatic diseases have multiple and diverse etiologies. They are caused by a whole series of social, biological and psychic factors that trigger the disease and can prolong it. Some of the most frequent and relevant causes are the following:
- Stress. Our body (soma and psyche) enjoys an internal equilibrium or homeostasis consisting of the proper functioning of a coordinated set of physiological processes, responsible for maintaining a constant equilibrium, regulating external influences and the body’s responses. Stress (or rather, the stress reaction) is the non-specific response that arises in the organism to any demand made on it that could alter its internal equilibrium (physical and psychological). This threat generates in the individual a situation of tension, effort and resistance which, if it exceeds his capacity to give an adequate response, causes the appearance of physical and psychological changes that affect the constancy of the internal equilibrium. Stress, then, consists of the effort made by the organism to adapt to the threat. If this situation is perpetuated, it can cause severe damage to the patient.
- Immunosuppression; deficit in the functioning of the immune system. Lack of adequate defenses to respond to certain external aggressions. Often this deficit appears in periods of intense and prolonged stress and suffering.
- Particular situations of the affective, labor and social life Strenuous work, exhausting sport, adverse climatic influence, very intense and routine domestic work, loss of loved ones, frustrations, disappointments, unfair marginalization and psychological mistreatment.
- Iatrogenic Iatrogenic are those diseases induced by the physician and his treatments. They appear when a patient is unnecessarily or erroneously medicated and made to feel sick and, sometimes, made sick by the unwanted effects of drugs that he/she does not need.
What are Psychosomatic Medicine treatments like?
Psychosomatic Medicine, based on a deep knowledge of the human body and mind, tries to identify the cause of the disease. To do this, it will use all the diagnostic tests and forms of examination that medicine provides (physical examination of the patient, image analysis, application of questionnaires, etc.). Once the cause is known, the objective will be to apply a therapeutic treatment, directed at the root of the process.
Although Psychosomatic Medicine is independent of Psychiatry and Psychology, it is common for the clinician to encounter pathological situations in which the psychosomatic component, present in all diseases, is so relevant that a psychological intervention is necessary, both to improve the evolution of the process and to accelerate healing and prevent relapses.
In a succinct but very eloquent way, one could explain the way Psychosomatic Medicine treats the sick with the famous phrase of the physician and humanist Gregorio Marañón: “there are no illnesses, only sick people”.
For more information, consult a specialist in Family Medicine.