心身医学, 行動医学, 生命倫理-私の歩みをめぐって

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The history of Psychosomatic Medicine began with the study of neurosis with somatic symptoms and soon progressed to the study of Psychosomatic Disorders centering around "Seven Holy Diseases". During that period Psychosomatic Medicine remained within the extention of the study of neurosis. For the past 10-20 years there have appeared the following new researches which have imposed fundamental changes on the concept of Psychosomatic Medicine.1. The proposal of the concept of "Alexithymia" which contributes to the differentiation of Psychosomatic Disorders from neurosis.2. The emergence of Biofeedback opened the way for instrumental learning of the autonomic bodily function and has stimulated attention to the inhibition or loss of normal susceptibility to bodily sensations in psychosomatic cases.3. Behavioral Medicine has advocated that the control of socioculturally conditioned self-destructive life habits such as smoking, insufficient bodily exercise, excessive alcohol intake and etc. is essential for the prevention, treatment and rehabilitation for those diseases which constitute the major cause of death at present. The advantage of behavioral therapies which provide us with brief, cost-effective and objective measures has more strongly appealed to general physicians rather than orthodox psychoanalitical approaches which are expensive and time-consuming.4. Noticeable progress in psychosomatic researches for serious organic diseases such as malignant tumors has facilitated the development of psychosomatic concept to Prof. G. Engel's "biopsychosocial medical model" which practically covers the whole medical field.5. The integration of humanistic psychology which signifies the essential difference between human and animal psychology has thrown light upon the treatment of so-called meaningless Psychosomatic Disorders and special care at clinically extreme situations.6. The importance of Bioethics is being stressed in the present medical circle. We envisage that this should help the improvement of quality of life under the collaboration with humanistic psychology rather than staying at the level of the claim of patient's right and physician's duty.7. Oriental thought and approaches have been drawing special attention in Western countries because of mind-body non-dualism, the importance of self-control methods of somatopsychic nature and Oriental existentialism. Oriental somatopsychic self-regulatory approaches are indispensable for dissolving the cortico-subcortical dissociation of the brain and restoring the harmony of cerebral function and should play a core role in holistic medical treatment.We should be open and flexible in our holistic treatment by integrating intuitive, comprehensive and existential approaches based on Oriental wisdom (awareness to the whole person due to mind-body non-dualism) and intellectual, conceptual and technological approaches of Western origin.
日本心身医学会の論文
1982-10-01

心身医学, 行動医学, 生命倫理-私の歩みをめぐって

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