Health Locus of Control
Psychosomaticism and Psychoimmunology
HLC and Psychosomaticism
Health Reality Models
The (Cultural) Etiology of Illness
Mode of Acculturation
Well-Being and Mode of Acculturation
Mode of Acculturation and HLC
Discussion of Results
Creativity Amidst Disillusionment
Stress in the 90's
When Externality is Better
Part I; Belief and Health
Have you ever gotten a headache after an argument? Have you ever noticed that there are
virtual epidemics of colds on campus during exam times? Have you ever broken out in hives because
you were nervous about something? Has your heart ever skipped a beat because you were shocked,
or had an intense emotional reaction? All involve complex pathways of the autonomic and
neuroendocrine systems of the Central Nervous System (CNS) which respond to internal and external
stimuli. The above examples illustrate how the mind and body interact and incite influence over each
other in this process.
Psychosomatic refers to the interaction between mind and body illustrated above. The
term psychosomatic, however, has taken on a variety of definitions since its inception. It is thus
important to specify which interpretation of the term is being used for this analysis. Heinroth coined
the term in 1818 from the Greek 'psyche' (soul or to breath) and soma (body) to "emphasize
multicausality and . . . interaction between the mind and body", and to help eliminate the lack of
integration between the medical and behavioral sciences (Fleming-Courts & Bartol, 1996). Bartol
and Eakes (1995) attempted to determine what the term means to individuals within the health care
industry. There were four major tenets:
[imaginary] an imagined physical disorder.
[structural] a physical structure disturbance mediated by emotional tension.
[functional] a disturbance of the function of an organ mediated by emotional tension.
[holistic] an approach to any state of the body taking into consideration psychic factors
in physical conditions and physical factors in psychic conditions.
-adapted from Bartol and Eakes, 1995.
The bidirectional, holistic (4) definition is consistent with the original definition and is the one I
use (even though psychic conditions are not addressed in the current discussion). Unfortunately,
Bartol and Eakes (1995) found that even individuals in the health care field espouse inaccurate
unidirectional (2 or 3), or imaginary (1) definitions, but that level of education moderated this.
The DSM-IV now refers to psychosomatic as 'psychological factors affecting medical condition',
also exhibiting a unidirectional bias. Likewise, unidirectional or imaginary assumptions of the
term are assumed by non-medical experts, which Fleming-Courts and Bartol (1996) believe is
reflective of the conceptions of their caregivers. The alternative term psychophysiological has
emerged, which perhaps carries less of the societal stigma (ie., as imaginary) attached to the word
'Holistic', in the sense that the World Health Organization described it (1978), is consistent with how this paper views psychosomaticism:
that of viewing a man in his totality within a wide ecological spectrum, and of emphasizing
the view that ill health or disease is brought about by an imbalance, or disequilibrium, of
man in his total ecological system and not only by the causative agent and pathogenic
evolution. -Bodeker, 1994, 279-80.
This adheres to the diathesis stress model, which explains dysfunction (ie. schizophrenia)
according to biological, psychological, and sociocultural factors (Comer, 1998). Health is a
natural state. Illness is an imbalance in homeostasis. Both are mediated by physical/ psychosocial
Psychosomatic is not psychogenic:
I would like to emphatically caution the reader against the assumption that the mind has
sole control over the manifestation of our (ill) health. It is far from my intention to imply that all
physical afflictions are derived solely or even mainly from psychic forces ('it's all in your head'/
psychogenic). Such a belief system is demonstrated in the following stigmatization of the victim:
the impression that the "person chose to be ill, perhaps to get attention, or that the person could
become well simply by making a choice for health and giving up the benefits its illness affords"
(Bartol & Eakes, 1995, p. 28). This may lead caregivers to regret or disparage their patients
(Bartol & Eakes, 1995). Feeling "discounted, labeled or ignored", furthermore, has detrimental
effects on the level of self-esteem/ hope of these individuals, possibly discouraging them from
seeking care when needed (Bartol & Eakes, 1995; Fleming-Courts & Bartol, 1996). Just because
the mind exerts influence over our physical body, does not negate the fact that physical factors are
involved in every aspect of health. Factitious or somatoform disorders, which do rely more
heavily on psychic forces, will not be addressed in this study. What I am considering is that the
mind and body are not autonomous, mutually exclusive systems.