Crocks, Quacks, and Shrinks

  • Ian E. Wickramasekera


In 1950, health care costs accounted for 4.6% of the gross national product. In 1985, health care costs accounted for 10.8% of the gross national product (Cohen, 1985). Sophisticated biomedical technology and expensive medical tests have contributed to this cost escalation (Culliton, 1978). This massive increase in health care costs appears to have occurred without a comparable increase in health status (DeLeon & VandenBos, 1983) of United States citizens as measured by morbidity, mortality, longevity, and so on.


Biomedical Model Psychosocial Distress Medical Utilization Autogenic Training Medical Care Utilization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ader, R. (Ed.) Psychoneuroimmunology. New York: Academic Press, 1981.Google Scholar
  2. Ader, R., and Cohen, N. Behavior and the immune system. In W. D. Gentry (Ed.), Handbook of behavioral medicine. New York: Guilford Press, 1984.Google Scholar
  3. Barber, T. X. Hypnosis: A scientific approach. New York: Van Nostrand Reinhold, 1969.Google Scholar
  4. Barsky, A. J., and Klerman, G. L. Overview: Hypochondriasis, bodily complaints, and somatic styles. American Journal of Psychiatry,1983, 140(3),273–283.Google Scholar
  5. Beecher, H. K. Measurement of subjective responses: Quantitative effects of drugs. New York: Oxford University Press, 1959.Google Scholar
  6. Benson, H. The mind/body effect. New York: Simon and Schuster, 1979.Google Scholar
  7. Blackwell, B. Minor tranquilizers: Use, misuse or overuse? Psychosomatics, 1975, 16, 28–31.PubMedGoogle Scholar
  8. Brodman, K., Mittelmann, B., Wechsler, D., Weider, A., and Wolff, H. The relation of personality disturbances to duration of convalescence from acute respiratory infections. Psychosomatic Medicine, 1947, 9, 37–44.PubMedGoogle Scholar
  9. Brown, J. W., Robertson, L. S., Kosa, J., and Alpert, J. J. A study of general practice in Massachusetts. Journal of American Medical Association, 1971, 216, 301–306.CrossRefGoogle Scholar
  10. Canter, A. Changes in mood during incubation of acute febrile disease and the effects of pre-exposure psychologic status. Psychosomatic Medicine, 1972, 34, 424–430.PubMedGoogle Scholar
  11. Canter, A., Cluff, L. E., and Imboden, J. B. Hypersensitive reactions to immunization innoculations and antecedent psychological vulnerability. Journal of Psychosomatic Research, 1972, 16, 99–101.PubMedCrossRefGoogle Scholar
  12. Cohen, W. S. Health promotion in the workplace: A prescription for good health. American Psychologist, 1985, 40(2),213–216.Google Scholar
  13. Culliton, B. J. Health care economics: The high cost of getting well. Science, 1978, 200, 883–885.PubMedCrossRefGoogle Scholar
  14. Cummings, N. A. The anatomy of psychotherapy under national health insurance. American Psychologist, 1977, 32, 711–718.PubMedCrossRefGoogle Scholar
  15. Cummings, N. A. Turning bread into stones: Our modern antimiracle. American Psychologist, 1979, 34 (12), 1119–1129.PubMedCrossRefGoogle Scholar
  16. DeLeon, P. H., and VandenBos, G. R. The new Federal Health Care frontiers: Cost containment and “wellness.” Psychotherapy in Private Practice, 1983, 1 (2), 17–32.Google Scholar
  17. Engel, G. L. The need for a new medical model: A challenge for biomedicine. Science, 1977, 196, 129–136.PubMedCrossRefGoogle Scholar
  18. Evans, F. J. The placebo in pain reduction. In J. J. Bonica (Ed.), Pain advances in neurology. New York: Raven Press, 1974.Google Scholar
  19. Fineberg, H. V. Paper presented at the Sun Valley National Forum, Sun Valley, Idaho, August 1977.Google Scholar
  20. Frazier, H. S., and Hiatt, H. H. Evaluation of medical practices. Science, 1978, 875–878.Google Scholar
  21. Friedman, M., and Rosenman, R. H. Type A behavior and your heart, New York: Knopf, 1974.Google Scholar
  22. Garfield, S. R., Collen, M. F., Feldman, R., Soghikian, K., Richart, R. H., and Duncan, J. H. Evaluation of an ambulatory medical care delivery system. New England Journal of Medicine, 1976, 294, 426–431.PubMedCrossRefGoogle Scholar
  23. Gibson, G., Bugbee, G., and Anderson, O. W. Emergency medical services in the Chicago area. Chicago: Center for Health Administration Studies, University of Chicago, 1970.Google Scholar
  24. Goldberg, D. P. Mental illness in the community. London: Tavistock, 1980.Google Scholar
  25. Hamburg, D. A., and Brown, S. S. The science base and social context of health maintenance: An overview. Science, 1978, 200, 847–849.PubMedCrossRefGoogle Scholar
  26. Hilgard, E. R. Hypnotic susceptibility. New York: Harcourt, Brace and World, 1965.Google Scholar
  27. Imboden, J. B., Canter, A., and Cluff, L. E. Convalescence from influenza. Archives of Internal Medicine, 1961, 108, 393–399.PubMedCrossRefGoogle Scholar
  28. Ingelfinger, F. J. Medicine: Meritorious or meretricious. Science, 1978, 200, 942–946.PubMedCrossRefGoogle Scholar
  29. Jemmott, J. B., and Locke, S. E. Psychosocial factors, immunologic mediation, and human susceptibility to infectious diseases: How much do we know ? Psychological Bulletin, 1984, 95, 52–77.CrossRefGoogle Scholar
  30. Jencks, S. F. Recognition of mental distress and diagnosis of mental disorder in primary care. Journal of American Medical Association, 1985, 253 (13), 1903–1906.CrossRefGoogle Scholar
  31. Jones, K. R., and Vischi, T. R. Impact of alcohol, drug abuse and mental health treatment on medical care utilization. Medical Care, 1979, 17, 1–82.PubMedGoogle Scholar
  32. Knowles, J. H. The hospital. Scientific American, 1973, 229, 128–137.PubMedCrossRefGoogle Scholar
  33. Krantz, D. S., Grunberg, N. E., and Baum, A. Health psychology. Ann ual Review of Psychology, 1985, 36, 349–385.CrossRefGoogle Scholar
  34. Lowy, F. H. Management of the persistent somatizer. International Journal of Psychiatry Medicine, 1975, 6, 227–239.CrossRefGoogle Scholar
  35. Mumford, E., Schlesinger, H. J., Glass, G. V., Patrick, C., and Cuerdon, T. A new look at evidence about reduced cost of medical utilization following mental health treatment. American Journal of Psychiatry, 1984, 141 (10), 1145–1158.PubMedGoogle Scholar
  36. Orleans, C. T., George, L. K., Houpt, J. L., and Brodie, H. K. H. How primary care physicians treat psychiatric disorders: A national survey of family practitioners. American Journal of Psychiatry, 1985, 142 (1), 52–57.PubMedGoogle Scholar
  37. Pierson, R. Top 200 drugs of 1984: 2.1% increase in refills pushes 1984 RXs 1.7% ahead of 1983. Pharmacy Times, April, 1985, pp. 25–33.Google Scholar
  38. Rahe, R. H. Life changes and near-future illness reports. In L. Levi (Ed.), Emotions—Their parameters and measurement. New York: Raven, 1975.Google Scholar
  39. Rasmussen, A. J., Jr. Emotions and immunity. Annals of the New York Academy of Sciences, 1969, 164, 458–461.PubMedCrossRefGoogle Scholar
  40. Regier, D. A., Goldberg, I. D., and Taube, C. A. The de facto U.S. Mental Health Services System. Archives of General Psychiatry, 1978, 35, 685–693.PubMedCrossRefGoogle Scholar
  41. Reiman, A. S. The new medical-industrial complex. New England Journal of Medicine, 1980, 303 (17), 963–970.CrossRefGoogle Scholar
  42. Review Panel on Coronary-Prone Behavior and Coronary Heart Disease. Coronary-prone behavior and coronary heart disease: A critical review. Circulation, 1981, 63, 1199–1215.CrossRefGoogle Scholar
  43. Rogers, M. P., Dubey, D., and Reigh, P. The influence of the psyche and the brain on immunity and disease susceptibility: A critical review. Psychosomatic Medicine, 1979, 41, 147–164.PubMedGoogle Scholar
  44. Rosen, J. C., and Wiens, A. N. Changes in medical problems and use of medical services following psychological intervention. American Psychologist, 1979, 34, 420–431.PubMedCrossRefGoogle Scholar
  45. Shapiro, A. Placebo effects in medicine, psychotherapy, and psychoanalysis. In A. E. Bergin and S. Garfield (Eds.), Handbook of psychotherapy. New York: Wiley, 1971.Google Scholar
  46. Sklar, L. S., and Anisman, H. Stress and cancer. Psychological Bulletin, 1981, 89, 369–406.PubMedCrossRefGoogle Scholar
  47. Solomon, G. F. Emotion, stress, and the central nervous system and immunity. Annals of the New York Academy of Sciences, 1969, 164, 335–343.PubMedCrossRefGoogle Scholar
  48. Solomon, G. F., Amkraut, A. A., and Kasper, P. Immunity, emotions, and stress, with special references to the mechanisms of stress effects on the immune system. In H. Musaph (Ed.), Mechanisms in symptom formation. Basel, Switzerland: S. Karger, 1974.Google Scholar
  49. Spanos, N. P., and Barber, T. X. Toward a convergence in hypnosis research. American Psychologist, 1974, 29, 500–511.PubMedCrossRefGoogle Scholar
  50. Stroebel, C. F., and Glueck, B. C. Biofeedback treatment in medicine and psychiatry: An ultimate placebo ? Seminars in Psychiatry, 1973, 5, 379–393.PubMedGoogle Scholar
  51. Tancredi, L. R., and Barondess, J. A. The problem of defensive medicine. Science, 1978, 200 (4344), 879–882.PubMedCrossRefGoogle Scholar
  52. Whatmore, G. B., and Kohli, D. R. The physiopathology and treatment of functional disorders. New York: Grune and Stratton, 1974.Google Scholar
  53. Wickramasekera, I. The placebo effect and biofeedback for headache pain. Proceedings of the San Diego Biomedical Symposium. New York: Academic Press, 1977.Google Scholar
  54. Wickramasekera, I. A conditioned response model of the placebo effect. Paper presented at symposium on Nonspecific Effects in Biofeedback, Biofeedback Society of America, Albuquerque, New Mexico, February, 1978.Google Scholar
  55. Wickramasekera, I. A model of the patient at high risk for chronic stress-related disorders: Do beliefs have biological consequences? Paper presented at Annual Convention of the Biofeedback Society of America, San Diego, California, 1979.Google Scholar
  56. Wickramasekera, I. A conditioned response model of the placebo effect: Predictions from the model. Biofeedback and self-regulation, 1980, 5 (1), 5–18.PubMedCrossRefGoogle Scholar
  57. Wickramasekera, I. A model of people at high risk. Paper presented at the International Stress and Tension Control Society, Brighton, England, August 1983.Google Scholar
  58. Wickramasekera, I. The placebo as a conditioned response: With 17 predictions from the model. In L. White, B. Tursky, and G. E. Schwartz (Eds.), Placebo: Clinical phenomena and new insights. New York: Guilford Press, 1985.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Ian E. Wickramasekera
    • 1
  1. 1.Behavioral Medicine Clinic and Stress Disorders Research LaboratoryEastern Virginia Medical SchoolNorfolkUSA

Personalised recommendations