こころとからだの<間> : その病としての精神障害(<特集>こころとからだの<間>)

概要

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This article presents a view of mental disorders as illnesses of mind-body discord. It describes two forms of discord : alienation of the body, and somatization of the mind. This is followed by illustrations and discussion of three clinical examples : a case of eating disorders comorbid with factitious disorder ; a case of autocastration ; and finally, a case of delusional personality disorder which ended in suicide. It is stressed that the two forms of discord are observed in most mental disorders ; that they are often interrelated and appear simultaneously rather than independently ; and that, in milder forms, they are observable in healthy individuals as well. It is argued that these may serve as indicators of some dissonance between mind and body, motivating the individual to restore a condition of harmony. Although the exact mechanisms behind this restoration process are as yet unknown, it can be facilitated by psychotherapy, religion, art, and more commonly, reduction of stress or increase of satisfaction in life. It is contended that experience of "love" may sometimes play a crucial role in this process, as is true in the three cases illustrated. Finally, this article discusses the implication of studying such phenomena in relation to the unfortunate estrangement of psychology and biology that currently overshadows the field of psychiatry.
2003-03-31