A Critical Examination of Some Recent Theoretical Models in Psychosomatic Medicine

Abstract

Summary The unscientific attitudes of many psychosomatic publications are discussed. Dunbar's "personality profiles," Alexander's "emotional specificity," and Wolff's "protective adaptive reaction" are presented as an introduction to the concept of "physiological regression" as discussed by Michaels, Margolin, Szasz, Hendrick, and Grinker. Various errors in the above theories are discussed and an attempt is made to show how they arose, why they are misleading and how they may be avoided. In doing this, the following are dealt with: A tendency to biased selection of clinical and physiological data to prove a given point The confusion between phenomenological description and etiology. The belief that there must be one, and only one, theory to "explain" the etiology of psychosomatic illnesses. The questionable assumption that parasympathetic hyperactivity is synonymous with, or a necessary concomitant of, psychosomatic illness. The analogical reasoning on which "regression terminology" has been founded. The conceptual errors which result when psychosomatic illness and physiological malfunctioning are not properly differentiated. The unproved assumption that psychoses and psychosomatic illness have a definite relationship. We conclude that many of the above theoretical models have served to produce new terms only, and that they impart no useful or verifiable information, and that the main problems posed by psychosomatic illnesses will remain with us until painstaking empirical observations and factual report complement theorizing.