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What We Know and What We Don’t: The Influence of Psychological Factors on Medical Illness

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Abstract

Early psychoanalytic researchers attempted, with varying degrees of success, to prove that psychological conflicts are complicit in medical illness. Ironically, current medical research indicates that psychological issues do in fact, play a role in the development or exacerbation of illness. The relationship between psychology and illness exists not because of the nature or symbolism of neurotic conflicts per se, though it's certainly possible that someone with a number of unconscious conflicts might be more vulnerable to the psychological states that are linked with disease. Current research suggests that it is actual physiological consequences of psychological disorders that explains the findings that some emotional factors are associated with disease.

Although many questions remain about these associations, there are at least two pathways thought to partially explain the influence of emotional functioning on the body. The first is that certain psychological disorders and personality traits affect the likelihood of engaging in high-risk health behaviors. Second, certain psychological states, when they persist over time, cause physical changes that increase the risk of disease.

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Notes

  1. 1.

    The problem of what are real illnesses vs. psychosomatic illnesses is extremely complicated. Medical science has historically had difficulty with dealing with patients who have physical symptoms without demonstrated illness patterns, which easily lead to diagnosis. The risk in describing illness as merely psychological or physical is that certain patient populations can be marginalized. For example, more recent research in patients with fibromyalgia indicates that autoimmune forces may be an influence in this disease (E.g., Staud, 2006). This group of patients (mostly women) has been subject to accusations that their illness is purely “psychosomatic,” because of a lack of research that explained their symptoms. An appreciation for a combined influence of both psychological and biological factors in disease would better serve patients, as illness is a complex interaction of biological factors and psychological influences.

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Correspondence to Tamara McClintock Greenberg .

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Greenberg, T.M. (2009). What We Know and What We Don’t: The Influence of Psychological Factors on Medical Illness. In: Psychodynamic Perspectives on Aging and Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0286-3_8

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