Psyche, Soma, and Society: The Social Construction of Psychosomatic Disorders

Abstract

Since World War Two, there has been increasing interest in the concept of “psychosomatic” disorders. A new field of study — psychosomatic medicine — has been developed, with the aim of understanding ill-health from a more holistic perspective; its purpose, according to Lipowski (1968), is “to study, and to formulate explanatory hypotheses about, the relationships between biological, psychological, and social phenomena as they pertain to person.” As a result of this approach, a wide range of conditions have been described, all of which have some psychosomatic component (Knapp 1980). However, little research has been done on how — and why — the diagnosis of “psychosomatic” disorder is negotiated between clinicians and patients, and on the lay explanatory models (See Kleinman 1980:105) used by patients with these conditions. In particular, it is important to understand how these patients make sense of their physiological experiences, of the diagnostic label of “psychosomatic,” and of the “stress,” “emotions” or “tension” said by clinicians to cause or exacerbate their disorders. The pilot-study described below attempts to shed light on these problems, in the case of certain gastrointestinal and respiratory conditions.