Psychosomatics – integration or polarization

Abstract

The paradigm shift from the dualistic (polar) to the multifactor bio-psycho-social view is common knowledge nowadays and is supported by neurobiological findings. Children who were often beaten or mistreated show psychobiological scars and scars of behaviour, thus not only mental disorders but also somatic diseases such as diabetes (type 2). During their lifetime, these populations often suffer from strokes and heart diseases. Thanks to magnetic resonance imaging and new studies it is now possible to demonstrate scientifically the statements of psychoanalysis and psychosomatic medicine: early traumata and debarment cause somatoform disorders, mental and somatic illnesses, which often become manifest only after many years or decades. New options in treatment can be seen in psychoeducation, where the patients are informed of the neurobiological findings. Unfortunately this is sometimes quite difficult with patients who speak foreign languages. The therapeutic procedure in the practice of the family doctor is dependent on his education and is described in details. Although one could believe that the paradigm shift should be well known and realized in daily practice, reality shows something else: psychic diagnoses are refused, the therapies are said to be too expensive, and among physicians these “difficult patients” are unpopular. Furthermore the medical doctors who work psychosomatically in Switzerland are bothered by the association of health insurance companies every year with threats of clawback because they seem to be “too expensive”.

Keywords Psychosomatics; Trauma; Psychosocial stress; Protective factor; Health insurance