Medicine that crosses the mind/body divide
While enjoying Aida Edemariam's review of current neuro-psychological research (The mind/body revolution: how the division between 'mental' and 'physical' illness fails us all, 26 January), I disagree with her assertion that 'A conceptual division between mind and body has underpinned western culture, and medicine for centuries. Illnesses are 'physical', or they are 'mental'.'
Samuel Taylor Coleridge coined the term 'psychosomatic' in the late 18th century to describe bodymind conditions, while the term 'placebo' was first used in the same period, referencing a link between imagination and physical symptom. A few years later, in 1800, the physician John Haygarth published the widely read pamphlet Of the Imagination As a Cause and a Cure of Disorders of the Body.
Franz Anton Mesmer (a friend of Haydn and Mozart) had infamously 'treated' so-called hysteria (a term invented by Hippocrates in the 5th century BC to describe a psychological condition noted in women, spuriously thought to be caused by a 'restless womb') with a combination of music-induced relaxation augmented by hypnotic suggestion and a questionable use of magnets passed over the body. This concentrated on what would come to be known as 'erogenous zones'.
Mesmer's work with 'animal magnetism' was discredited, but nevertheless influenced the neurologist Jean-Martin Charcot, who – in the late 19th century – treated so-called hysterics at the Salpêtrière hospital in Paris through induction of hypnotic trance and suggestion.
During the winter of 1885-86, Sigmund Freud attended Charcot's theatrical demonstrations of psychosomatic treatment of women patients, where his idea of a deep relationship between body and mind – as a symptom linked to repression – was formed. Drawing on Suzannah Jones's work arguing that, in comparison with men, women are airbrushed from history, we might note that historically the 'psychosomatic' in medicine is largely gendered as 'women's issues'. Or the rest is 'hystery'.Alan BleakleyEmeritus professor of medical humanities, Plymouth Peninsula School of Medicine
Aida Edemariam's article is magnificent. I have been waiting for it for years. I can say that I have been talking about monism all my career. The damage Descartes dealt us reached very far, even into the phraseology we use, not only when we talk about illness. As a consultant psychiatrist, I regularly used to draw attention to dualism in ward rounds and meetings. 'It's physical,' colleagues would say to exclude a condition from our interest, to which I would retort: 'Everything is physical.' I also noticed that many patients with anxiety and obsessional disorder, as well as functional disorders, seemed to conceptualise their condition in the most dualistic way. They would say: 'It's not me, doctor – it's my mind.' I maintain that the word 'mind' should be treated as a verb, not as a noun. It's an activity carried out by the brain at its highest level of functioning.Name and address supplied
This article was a well-written summary of an understanding that I have used to hack my wiring as part of recovery from long Covid. Many others are doing this for conditions such as fibromyalgia (which the article mentions) and ME (or CFS – chronic fatigue syndrome).
The role of the mind in illness is difficult to explain in a way that resonates with most people and is not interpreted as dismissive or as saying: 'It's all in the head.' The article does a really good job of this, and so it is a shame that illnesses including ME and long Covid are not even mentioned. Far more people suffer from long Covid today, for example, than most of the conditions mentioned in the article.While this knowledge is helping many, it could help so many more people if it were more widely understood by both medical practitioners and society in general. Those searching online using 'ME' or 'long Covid' will miss this piece of otherwise excellent journalism and, potentially, the understanding that can help them recover. That is the real shame.Julie BlackLaurencekirk, Aberdeenshire
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