Mental Imagery pp 167-177 | Cite as

Imagery and the Sinistrality of Symptoms

  • Paul Bakan

Abstract

I would like to consider a phenomenon which has been observed over many years, namely, the greater likelihood of symptoms, especially psychogenic symptoms, on the left side of the body, i.e. the sinistrality of symptoms. The symptom is at the heart of all medical encounters. This encounter begins with one symptom and then goes on to diagnosis, prognosis and treatment. But at the very core of this encounter, in the very conception of the symptom, there is a semantic confusion which becomes obvious in distinctions between organic and functional, real and imaginary, organic and hysterical and so on. It was the problem of hysterical symptoms which gave rise to psychoanalysis and its many psychotherapeutic offshoots. The possibility of a relationship between imagination and symptom formation was seriously considered well before the nineteenth century. Let us consider Robert Burton’s seventeenth century work, The Anatomy of Melancholy (Burton, 1948), for some historical perspective on this matter. Burton was a Christian minister, whose book was referred to by the famous physician William Osier as “a medical treatise, the greatest indeed written by a layman...” (Jackson, 1989). Burton saw the root cause of melancholy or depression, as well as other symptoms, in a “damaged imagination”, i.e. an imagination which somehow had escaped from the control of reason to become a faculty that “is most powerful and strong, and often hurts…”. The faculty of imagination when corrupted, hurt, misaffected, depraved, or damaged, he saw as the cause of melancholy. The damaged imagination, he said, misrepresents matters to the understanding, and makes patients see and hear “that which indeed is neither heard nor seen”. Burton seems to be distinguishing here between imagery and perception. In reviewing the work of other physicians Burton singles out the work of Thomas Fienus (1567–1631) for whom he had the highest regard, referring to him as “worth all of them together” (Rather, 1967). Fienus presented a model in which the imagination was seen to stir up the emotions—leading to bodily changes in the humours and spirits, which in turn lead to bodily symptoms. This is essentially a psychosomatic model, wherein a disturbed imagination produces physiological changes leading to psychogenic symptoms. This sixteenth century model prefigures contemporary understanding of the relationship between imagination and symptoms.

Keywords

Burning Fatigue Depression Dopamine Migraine 

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Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Paul Bakan
    • 1
  1. 1.Psychology DepartmentSimon Fraser UniversityBurnabyCanada

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