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On the Natural History and Suggested Management of Psychosomaticism

Posted: 08 Sep 2011 08:11 PM PDT

I am very pleased to be able to feature a piece of original writing here on MH Blog, authored by Julia Geynisman, a fourth-year medical student at the University of Michigan. The piece is entitled "The Natural History and Suggested Management of Psychosomaticism." Ms. Geynisman was kind enough to permit me to post a copy of her interesting and insightful meditation, which I will excerpt here:

. . . overwhelmingly, patients with psychosomatic illnesses have some degree of mental anguish. They are battling depression or are living with anxiety. They have a history of one major trauma or have lived lives of daily trauma. They have unresolved conflicts with others or unfulfilled aspirations; they may need validation about the choices they have made.

In an era in which we have functional MRIs to help us study every neuron of the brain and in which we know so much about the molecular mechanisms of our bodies, how can we reconcile the normal results of our scans and lab tests with the tired eyes, weak gait, and crippled spirit of the patient before us? Psychosomatic disorders challenges us to sit with the uncomfortable question of whether we believe our mind and body are two separate entities or one whole organism.

What follows is an elegant meditation on the lived experiences of so-called psychosomatic illnesses, and on the problems posed by the apparent necessity of the biological model of illness that rests fundamentally on the existence of discrete, material pathologies that can be clinically correlated. Because I believe that the foundations of this model in Western allopathic medicine have had devastating consequences for the family of contested illnesses that do not typically present with such pathologies, readers should be unsurprised that I found so much to like in Ms. Geynisman's essay.

One of the most important aspects in thinking about the relationship between mind and body is subjectivity, which is something of an allegory for the medical and health humanities insofar as studies in the latter often begin by centering the subject rather than objectifying. To that end, the writer is always a critical feature of a medical humanities analysis, and Ms. Geynisman was kind enough to write a short account of how and why she came to be interested in the concept of psychsomaticism.

This account is at once personal, heartfelt, and well-written, like the essay itself. In the combination of subjectivity, judgment, and the use of erudition as a means of encouraging virtuous engagement with the world -- Ms. Geynisman is interested in this subject at least in part because of its implications for her future practice as a physician -- Ms. Geynisman's work exemplifies the best features of the essay form itself.

Comments and thoughts are of course most welcome, posted here or directed to Ms. Geynisman herself. The essay may be downloaded here:

Download The Natural History and Suggested Management of Psychosomaticism - FINAL

The account describing the rationale for writing the essay may be downloaded here:

Download Comment Geynisman Psychosomaticism