PSYCHOSOMATICS 



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import of this statement can be readily realized by 

 reading aloud any sentence and comparing its mean- 

 ing with what is obtained when it is read aloud back- 

 wards. Although the same amount of energy is ex- 

 pended in each case, the disparity in the amount of 

 information that is obtained is not in itself physically 

 quantifiable. In the light of present knowledge it may 

 be inferred that the central nervous system derives in- 

 formation on the basis of changing patterns of neuronal 

 activity. The patterns are of themselves without sub- 

 stance, but they depend on physicochemical processes 

 within nervous tissue. How the nervous system recog- 

 nizes these patterns and uses them to make decisions 

 is, of course, a complete mystery. 



Before making the next step, it may be well to recall 

 that had it not been for reasoning based on introspec- 

 tion there would be no occasion to be dealing with 

 psychological problems. Through introspection it has 

 been recognized that there are various kinds of in- 

 formation which are subjective in nature and which 

 are variously appreciated in the form of awareiu^, 

 feelings, perceptions, emotions and thoughts. Figura- 

 tively speaking, it was as though the nervous system 

 could hold up (he mirror of subjectivity to itself as a 

 means of reflecting information. At tin- same time it is 

 evident that numerous informational transactions are 

 carried on within the nervous system without a sub- 

 jective counterpart. 



It has been argued that subjectivity is an epi- 

 phenomenon which is not essential to what the central 

 nervous system performs. The fact, however, that 

 subjective information represents information over 

 and above what the organism would otherwise have, 

 makes this seem unlikely. In other words the fact that 

 it exists at all means that it is an added source of 

 information which an organism can draw upon in 

 adjusting to its environment. At all events, it must be 

 admitted that it is an important factor in verbal com- 

 munication between human beings. 



Definition of Psv< hologu al Process and Psyt he 



It is the element of subjectivity that most clearly 

 distinguishes psychological from other functions of the 

 nervous system. In the light of this and the foregoing 

 considerations, a psychological process might be in- 

 ferentially defined as a neuronally determined process 

 which derives information in conjunction with some 

 element of subjectivity and which may or may not 

 use this information to effect a decision. When we 

 come to consider methodological questions, it will be 

 seen that such a definition is compatible with scientific 



objectivity. For a given organism, the psyche would 

 represent the sum of its transpiring psychological 

 processes in their dynamic relationship with one 

 another. For the sake of emphasis, it will be restated 

 that the informational aspects of the psyche are in- 

 separable from a neuronal substrate. When so under- 

 stood, the main logical objection to the term psy- 

 chosomatic is circumvented. 



HISTORICAL NOTE 



It is now such accepted practice to consider the role 

 of psychological factors in the diagnosis and treatment 

 of disease that physicians who have trained since the 

 last war find it difficult to realize that psychosomatic 

 medicine is a development only of tin- past three 

 decades. The lateness in this development can be 

 attributed in the traditional physiological concept 

 that tli- ( i rubrospinal and autonomic nervous systems 

 functioned independently of one another. This con- 

 i epl won its w.i\ into medical doctrine on the strength 

 ol Bichat's Recherches physiologiques nu !,i vie et la mort, 

 published in 1800 (8). Ironicalh, enough, Freud (19), 

 who was to lead .1 revolution in psychology which has 

 affected practicalK ever) facet of modern life, was so 

 indoctrinated with the teaching that the so-called 

 voluntary and involuntary systems functioned inde- 

 pendently that he was unable to perceive the applica- 

 tion of his theory to one of the most important aspects 

 of human experience and behavior. Consequently, 

 although he could see a read) explanation of how 

 psychological disturbances could lead to hysterical 

 manifestations in parts of the body under the control 

 of the "voluntary' nervous system, he believed that 

 visceral symptoms could not be psychological in 

 origin. 



There were many precedents that were conducive 

 to the ideas expressed in Bichat. First, there were the 

 Greek notions pertaining to the differences between 

 •animal' and 'vegetative' life; to the role of the four 

 humors in temperament and organ function; and to 

 the magical power of one part of the body to affect 

 another part, including the brain itself, through 

 'sympathy'. Second, there was Galen's distinction 

 between voluntary and involuntary functions which 

 w .is later elaborated upon by Fernel, Descartes, Willis, 

 Whytt and others. Third, and most important, was a 

 change in anatomical interpretation that stemmed 

 from Pourfour du Petit's discovery in 1727 that the 

 system of nerves and ganglia related to the viscera was 

 not connected to the brain, as had previouslv been 



