CHAPTER LXIX 



Psychosomatics 



PAUL D. MacLEAN 



Laboratory of Neurophysiology, Xational Institute of 

 Mental Health, Bethesda, Maryland 



CHAPTER CONTENTS 



Problem of Term 'Psychosomatic' 

 Soma 

 Psyche 



Psyche as Information 



Definition of Psychological Process and Psyche 

 Historical Note 



Psychosomatic Disorders 

 Role of Neurophysiology in Psvchosomatics 

 Questions of Definition and Methodology 



Behavior and communication of information 

 Kinds of psychological information 

 Kinds of emotional information 

 Assessing emotion in animals 

 The Problem for Neurophysiology 

 Central Mechanisms of Emotion 

 Brain Stem and Spinal Cord 

 Decerebrate preparations 

 Hypothalamus and midbrain 

 Basal Ganglia 

 Cerebral Cortex 

 Neocortex 



The phylogenetically old cortex 

 Self-preservation 

 Preservation of the species 

 Mass function of limbic system 

 Nature of Neural Apparatus Involved in Emotion 

 Anatomical Differences 

 Electrophysiological Differences 

 Biochemical Differences 

 Limbic and Prefrontal Cortex 

 Relevance to Specific Psychosomatic Problems 

 Primitive psychological processes 



Primitive psychological processes and brain mechanisms 

 Reciprocal relationship of limbic lobe and neocortex 

 The Problem in Regard to Formation of Lesions 

 Acute Emotional States 

 Chronic Emotional States 

 'General Adaptation Syndrome' 

 Peptic Ulcer 



Experimental Failure to Induce Lesions 

 Possible explanation 

 Suggestions in regard to further research 



Problem of speeilu ii\ 



Learning and memory 



in adopting the use of the new term 'psychosomatics' 

 the editors of" this Handbook have taken cognizance of a 

 developing, specialized field of interest in which neuro- 

 physiology has joined hands with psychology, psychia- 

 try .ind internal medicine. The term is here understood 

 to refer to the pursuit of knowledge that is con- 

 cerned with the explanation of why and how psycho- 

 logical processes find expression through transient or 

 enduring changes within the body. It thus dis- 

 tinguishes a field of Study thai focuses attention on 

 mechanisms accounting for changes within the body 

 as opposed to those between the organism and its 

 external environment. Stated otherwise, 'psychoso- 

 matics' is primarily concerned with the influence of 

 psychological processes on interofective systems. 



The recent emphasis on the importance of psychso- 

 matics may be attributed to the growing impression of 

 the medical profession that psychological factors 

 account for a large proportion of illnesses in which the 

 presenting symptoms are physical in nature. It has 

 been inferred that such factors are not only at the 

 basis of a variety of 'function, if disorders, but are also 

 of etiological significance in a number of diseases 

 complicated by single or multiple lesions (68, 70). 



PROBLEM OF TERM 'PSYCHOSOMATIC' 



In order to clear the way for meaningful exposition 

 it will be necessary to deal with some semantic prob- 



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