EMOTIONAL INTELLIGENCE: THE BIOMEDICAL MODEL OF PSYCHOSOMATIC DISORDERS
THE BIOMEDICAL MODEL OF PSYCHOSOMATIC DISORDERS
The biomedical model emphasizes the diathesis underlying psychosomatic
illness. There are four components that fall under the biomedical view: genetic,
specific organ vulnerability, evolutionary selection, and the general
adaptation syndrome. These components do not all exclude one another,
and most biomedical theorists emphasize more than one of them when explaining
psychosomatic disorders.
Genetic
Is the predisposition to psychosomatic disorders genetically inherited? We
have seen evidence that this is so for both hypertension and ulcers. If one
identical twin has ulcers or hypertension, then his co-twin is more likely to
have ulcers or hypertension than is the case between fraternal twins. All the
genes of two identical twins are the same, but only half the genes off paternal
twins are the same. The higher concordance of identical twins is most likely
explained by genetics, since the environment fraternal twins share is probably
almost as similar as that of identical twins. In the case of peptic ulcer,
similar over secretion of gastric juices or weakness of the mucous membrane
of the stomach, each producing similar vulnerability to ulcers, is probably
what is inherited. It is unknown what is inherited in the case of high blood
pressure.
Specific Organ Vulnerability
A variant of the genetic view holds that it is weakness in a specific organ that
is inherited. That is, when an individual is stressed, the weakest link in his
bodily chain snaps. The hypothesis that over secretion of stomach acid is an
inherited cause of ulcers is an instance of the specific organ vulnerability
hypothesis. Organ specificity is confirmed by the fact that individuals tend
to react to stress with one characteristic part of the body. Some of us usually
react to stress with a queasy stomach, others with headache, others with
sweating, and still others with a racing heart. Patients with hypertension
tend to react to threatening stimuli with an increase in blood pressure, patients
with ulcers react with gastric secretion, and patients with recurrent
headaches tend to react with increased muscle tension (Malmo and Shagass; Lacey).
Evolution
Evolution may have actually favored the development of certain psychosomatic
disorders. Consider the emergency reaction for which evolution has
clearly selected. In a generally threatening environment, individuals who
tended to perceive the world as hostile and responded crisply with elevation
of blood pressure, muscle tension, and the like would be those most likely to
survive and reproduce. Only under modern conditions, in which the level of
physical threat has been reduced from the days of the cave and the jungle, is
hypertension considered a disorder rather than a strength. Notice that hypertension
does not kill young persons; it is deadly to individuals who are many years past the
prime age of reproduction. This seems to suggest that tendencies to various
psychosomatic disorders are inherited because at one time in history
these "diseases" actually favored survival and reproduction.
Stress and the General Adaptation Syndrome
Hans Selye (1907-1983) integrated the emergency reaction of the sympathetic
nervous system into the major theory of reaction to stress. He emphasized
the stress side of the diathesis-stress model. Selye believed that the
general adaptation syndrome is nonspecific, that one and the same stress reaction
will occur to the whole gamut of disturbing events. He held that
when a human being or an animal is stressed, a sequence of three stages
called the general adaptation syndrome ensues. The first stage is the alarm
reaction. After an initial phase of lowered resistance, the system goes into
counter shock-the pituitary gland releases ACTH (adrenocorticotrophic
hormone) into the blood stream, which stimulates the adrenal cortex. This
throws the organism into the emergency reaction. If the alarm reaction stage
is successful, it restores bodily balance. The alarm reaction is followed by a
second stage-s-the stage of resistance, in which defense and adaptation are
sustained and optimal. If the stressor persists, the final stage, exhaustion,
ensues, and adaptive responding ceases. Illness and, in some cases, death
may follow (Selye, 1956).
The reaction of rats to long-term cold stress illustrates the general adaptation
syndrome. Rats were placed in a refrigerated room where the temperature
was near freezing. During the first forty-eight hours, the rats showed the
alarm reaction. They developed stomach ulcers, had swollen adrenals, and
showed the changes of the thymus gland. The rats
continued to live in this environment for many weeks. After five weeks, they
had apparently entered the stage of resistance, for when these animals were
placed in a still colder chamber they survived temperatures that animals
who had not become adapted could not withstand. Finally, the stage of exhaustion
was demonstrated. After several months in the cold room, these
rats could not survive a change to cold temperature that normal rats could
survive.
From the point of view of this theory, symptoms such as high blood pressure
and stomach ulcer may indicate that the individual is in an alarm reaction
to stress. The theory postulates that psychosomatic symptoms are
general stress reactions underlying the general adaptation syndrome (Selye,
1975; but see Mason, 1971, 1975a, 1975b).
THE PSYCHODYNAMIC MODEL
Diathesis and other biological considerations playa large role in the predisposition
to psychosomatic disorders, but there is also evidence that personality
and psychodynamics playa role as well These factors contribute to the
stress side of the diathesis-stress model.
Franz Alexander (1950, 1968) is the most influential psychoanalytic
theorist of psychosomatic disorders. His view integrates genetic organ vulnerability,
personality factors, and life stress. A person who is genetically
vulnerable in a specific organ and has specific psychodynamic conflicts will
develop disease of that organ when the stress of living arouses his psychodynamic
conflicts and he is no longer able to defend against them. All three
factors-a vulnerable organ system, an underlying dynamic conflict, and a
precipitating life situation-interact to produce the disorder. As we saw earlier,
the essence of the personality constellation for an individual who will
develop peptic ulcer is conflict over dependent needs versus independent
self-assertion, and the hypertensive conflict involves the damming up of
anger toward others. Alexander postulates other conflicts for asthma, arthritis,
and skin disorders.
As we have seen, some evidence supports this theory: from the psychological
profile alone, researchers have been able to pick out which male patients
have hypertension and ulcer well beyond the level of chance. Further, both
gastric secretion and blood pressure elevation occur when the relevant
emotions are aroused in individuals who have ulcers and hypertension.
BERAVIORAL AND COGNITIVE MODELS
Theories that stem from behavioral and cognitive views hold that learning
or cognition produces psychosomatic disorders, and they emphasize the
stress side of diathesis-stress. The stress can be produced by conditioning,
cognitions, or by life events.
Conditioning
The conditioning view of psychosomatic disorders maintains that the
symptoms are a conditioned response acquired when a neutral stimulus was
paired with an unconditioned stimulus that produced the disorder. For example,
asthma has been conditioned in the laboratory:
A thirty-seven-year-old shop assistant suffered from severe bronchia lasthma that
could be reliably set off by house dust. In the laboratory, she was sprayed with an
aerosol having a neutral solvent; the aerosol was to be the conditioned stimulus.
Following beings prayed with the aerosol, she inhaled house dust (unconditioned
stimulus), and an asthma attack (unconditioned response) followed. Thereafter,
upon inhaling from the aerosol, asthma attacks ensued. (Dekker, Pelse, and
Groen, 1957)
Since individuals who suffer from asthma sometimes have attacks following
exposure to highly specific events, such as experiencing a family argument
or other emotional conflicts, this is an appealing model of psychosomatic
illness. It has, however, only been demonstrated under
limited laboratory conditions and only some patients can be so conditioned.
Cognitions and Psychosomatic Disorders
Could it be that specific thoughts set off physical symptoms? William Grace
and David Graham argue that an individual's perception of the world and
what he thinks about threat predicts what psychosomatic disorder will develop.
This argument antedates, but is wholly compatible with the cognitive
model of abnormality. Grace and Graham interviewed 128 patients with a
variety of diseases to find out what situations immediately preceded
the onset of the symptoms and how the individual perceived what was happening
to him. They found specific thoughts associated with specific illnesses.
For example, individuals with high blood pressure were in a state of constant
preparation to meet all threats, and when confronted with threat they
thought, "Nobody is ever going to beat me. I'm ready for everything." Table
12-2 lists other illnesses that have specific thoughts associated with them
(Grace and Graham, 1952).
The modern cognitive school has yet to put forward a more articulate, research-
supported view, but we expect to see such a view within this decade.
Life Events
The final behavioral theory of psychological influence on illness involves life
stressors. It holds that stressful life events set off disease. If our reaction to
stress makes us susceptible to physical disease, then frequent stressful life
events should correlate with frequent disease. In the early pioneering research
on this question, Thomas Holmes and Richard Rahe devised a life
events scale, the Social Readjustment Rating Scale, by having individuals
rank the amount of stress different life events would cause them. Based on
these rankings, Holmes and Rahe assigned a number to each stressful event.
Death of a spouse was the most stressful life event; divorce
and separation were near the top; taking a new job in the middle; holidays,
vacations, and minor violations of the law were considered the least stressful.
The more life events an individual experiences, the more likely is he or
she to get sick from a variety of disorders. For example, individuals who had
heart attacks had more total significant life events in the six months prior to
their heart attack than in the year before. Similarly, individuals who became
depressed had a larger number of life events, particularly losses,
than those who did not (Holmes and Rahe, 1967; Paykel, Meyers, Dienelt, Klerman,
Lindenthal, and Peffer, 1969; Theorell and Rahe, 1971).
Since the construction of the Social Readjustment Rating Scale, investigators
have taken a closer look at the nature of the life events themselves.
First of all, some of the life events listed by Holmes and Rahe could themselves
reflect the fact of ongoing illness. For example, an individual might be
forced to retire (item 10) because he had high blood pressure, as opposed to
getting high blood pressure as a consequence of retiring. Modern investigations
of life events now distinguish between events that are confounded with
illness and those that might contribute to it (Dohrenwend and Dohrenwend,
1974).
Second, some of the life events are positive entrances, such as item 25,
outstanding personal achievement, while others are negative exits, like item
1, the death of a spouse. Losses or exits seem to produce more problems than
do entrances (Paykel, 1974).
Third, the repetitive, daily hassles of life may be better predictors of illness
than the major life events in Table 12-3. Losing your wallet, a price rise in
the weekly food bill, and the breaking of a window may ultimately push
health around more than deaths, divorces, and pregnancies (Kanner,
Coyne, Schaefer, and Lazarus, 1981). That is, it may be the gradual chipping
away at an individual by stresses that wear him or her down to a point where
susceptibility to illness jumps dramatically.
CONTROLLABLE VERSUS UNCONTROLLABLE LIFE EVENTS.
Another development in life events research concerns control over one's life. Recall
that David Glass argued that a Type A's vigorous struggle to control threat
followed by profound helplessness in the face of an uncontrollable event
predisposes him to coronary disease. Glass predicts that it is not life events
in themselves but uncontrollable life events that precede heart attacks, especially
among Type A's. Thus, he differentiates between uncontrollable and
controllable life events. For example, he categorized death of a close family
member, death of a best friend, and being laid off from work as uncontrollable
losses, but divorce, separation, and changes in eating habits as controllable
life events (Dohrenwend and Martin, 1978).
Three groups of patients answered a life events Questionnaire based on the
Social Readjustment Rating Scale. One group was in the coronary care unit
following heart attack, a second group was in the general medical and psychiatric
ward for non-coronary illnesses, and a third group was healthy. As
expected, the patients hospitalized for heart attacks tended to be Type A's,
whereas the patients hospitalized for non-coronary illnesses tended to be
Type B's. The three groups did not differ on total number of life events in the
preceding year. What distinguished the hospitalized groups from the non
hospitalized group, however, was the number of uncontrollable life events.
Both the individuals who had had heart attacks and the individuals who had
been hospitalized for other illnesses experienced more helplessness-inducing
life events than did the healthy controls. Taken together, these results
indicate that a combination of being a Type A and experiencing uncontrollable
life events-as opposed to a large number of life events per se-may be
a formula for heart attack (Glass, 1977).
SUMMARY
1. Psychological factors can influence the course, and even the beginning,
of a physical illness. Psychosomatic disorders are defined as physical
illnesses whose course or onset can be influenced by such psychological factors.
2. Psychosomatic disorders can best be viewed within a diathesis-stress
model. In this view, psychosomatic disorder occurs when an individual is
both constitutionally vulnerable to a particular physical problem and experiences
life stress.
3. Peptic ulcers occur when the naturally secreted hydrochloric acid of
the stomach erodes the protective mucous membrane of the stomach or duodenum.
Emotional states, particularly anxiety, can cause an oversecretion
of hydrochloric acid in the stomach.
4. Conflict, unpredictable bad events, and uncontrollable bad events all
produce anxiety and may all contribute to the formation of peptic ulcers.
5. Hypertension, or high blood pressure, like ulcers, is produced both by
constitutional, genetically inherited tendencies to high blood pressure, and
by psychological factors.
6. The emotional states of anxiety and hostility both produce increases in
blood pressure in the laboratory and in real life. Such an increase in blood
pressure is part of the adaptive emergency reaction to threat. Ifan individual
engages in it for a large proportion of his or her life, chronic and dangerous
hypertension will result.
7. Individuals who hold jobs that require constant vigilance arid personality
types who chronically view the world as hostile and threatening (Type
A) may be prone to high blood pressure and be at greater risk for heart attack.
8. Severe high blood pressure should be treated by anti-hypertensive
medication, but biofeedback, transcendental meditation, and relaxation can
all reduce mild hypertension.
9. When a person perceives the environment as threatening, but rather
than mobilizing against the danger, gives up, sudden death may occur.
10. Biomedical, psychodynamic, behavioral, and cognitive models have
all shed light on the causes and treatment of psychosomatic disorder. All are
compatible with the diathesis-stress perspective.
11. The biomedical view emphasizes the "diathesis" of the diathesisstress
model, and it argues that genetic inheritance and vulnerability in a
specific organ contribute to psychosomatic disorders.
12. The psychodynamic view emphasizes the personality types in whom
underlying dynamic conflicts, a vulnerable organ system, and a precipitating
life situation interact to produce psychosomatic disorders.
13. The behavioral and cognitive views emphasize the "stress" of the
diathesis-stress model. They hold that the way individuals learn to cope with
threat, think about threat, and the actual stressful and uncontrollable life
events that they experience play the major role in the way psychological
factors cause and aggravate physical illness.
The biomedical model emphasizes the diathesis underlying psychosomatic
illness. There are four components that fall under the biomedical view: genetic,
specific organ vulnerability, evolutionary selection, and the general
adaptation syndrome. These components do not all exclude one another,
and most biomedical theorists emphasize more than one of them when explaining
psychosomatic disorders.
Genetic
Is the predisposition to psychosomatic disorders genetically inherited? We
have seen evidence that this is so for both hypertension and ulcers. If one
identical twin has ulcers or hypertension, then his co-twin is more likely to
have ulcers or hypertension than is the case between fraternal twins. All the
genes of two identical twins are the same, but only half the genes off paternal
twins are the same. The higher concordance of identical twins is most likely
explained by genetics, since the environment fraternal twins share is probably
almost as similar as that of identical twins. In the case of peptic ulcer,
similar over secretion of gastric juices or weakness of the mucous membrane
of the stomach, each producing similar vulnerability to ulcers, is probably
what is inherited. It is unknown what is inherited in the case of high blood
pressure.
Specific Organ Vulnerability
A variant of the genetic view holds that it is weakness in a specific organ that
is inherited. That is, when an individual is stressed, the weakest link in his
bodily chain snaps. The hypothesis that over secretion of stomach acid is an
inherited cause of ulcers is an instance of the specific organ vulnerability
hypothesis. Organ specificity is confirmed by the fact that individuals tend
to react to stress with one characteristic part of the body. Some of us usually
react to stress with a queasy stomach, others with headache, others with
sweating, and still others with a racing heart. Patients with hypertension
tend to react to threatening stimuli with an increase in blood pressure, patients
with ulcers react with gastric secretion, and patients with recurrent
headaches tend to react with increased muscle tension (Malmo and Shagass; Lacey).
Evolution
Evolution may have actually favored the development of certain psychosomatic
disorders. Consider the emergency reaction for which evolution has
clearly selected. In a generally threatening environment, individuals who
tended to perceive the world as hostile and responded crisply with elevation
of blood pressure, muscle tension, and the like would be those most likely to
survive and reproduce. Only under modern conditions, in which the level of
physical threat has been reduced from the days of the cave and the jungle, is
hypertension considered a disorder rather than a strength. Notice that hypertension
does not kill young persons; it is deadly to individuals who are many years past the
prime age of reproduction. This seems to suggest that tendencies to various
psychosomatic disorders are inherited because at one time in history
these "diseases" actually favored survival and reproduction.
Stress and the General Adaptation Syndrome
Hans Selye (1907-1983) integrated the emergency reaction of the sympathetic
nervous system into the major theory of reaction to stress. He emphasized
the stress side of the diathesis-stress model. Selye believed that the
general adaptation syndrome is nonspecific, that one and the same stress reaction
will occur to the whole gamut of disturbing events. He held that
when a human being or an animal is stressed, a sequence of three stages
called the general adaptation syndrome ensues. The first stage is the alarm
reaction. After an initial phase of lowered resistance, the system goes into
counter shock-the pituitary gland releases ACTH (adrenocorticotrophic
hormone) into the blood stream, which stimulates the adrenal cortex. This
throws the organism into the emergency reaction. If the alarm reaction stage
is successful, it restores bodily balance. The alarm reaction is followed by a
second stage-s-the stage of resistance, in which defense and adaptation are
sustained and optimal. If the stressor persists, the final stage, exhaustion,
ensues, and adaptive responding ceases. Illness and, in some cases, death
may follow (Selye, 1956).
The reaction of rats to long-term cold stress illustrates the general adaptation
syndrome. Rats were placed in a refrigerated room where the temperature
was near freezing. During the first forty-eight hours, the rats showed the
alarm reaction. They developed stomach ulcers, had swollen adrenals, and
showed the changes of the thymus gland. The rats
continued to live in this environment for many weeks. After five weeks, they
had apparently entered the stage of resistance, for when these animals were
placed in a still colder chamber they survived temperatures that animals
who had not become adapted could not withstand. Finally, the stage of exhaustion
was demonstrated. After several months in the cold room, these
rats could not survive a change to cold temperature that normal rats could
survive.
From the point of view of this theory, symptoms such as high blood pressure
and stomach ulcer may indicate that the individual is in an alarm reaction
to stress. The theory postulates that psychosomatic symptoms are
general stress reactions underlying the general adaptation syndrome (Selye,
1975; but see Mason, 1971, 1975a, 1975b).
THE PSYCHODYNAMIC MODEL
Diathesis and other biological considerations playa large role in the predisposition
to psychosomatic disorders, but there is also evidence that personality
and psychodynamics playa role as well These factors contribute to the
stress side of the diathesis-stress model.
Franz Alexander (1950, 1968) is the most influential psychoanalytic
theorist of psychosomatic disorders. His view integrates genetic organ vulnerability,
personality factors, and life stress. A person who is genetically
vulnerable in a specific organ and has specific psychodynamic conflicts will
develop disease of that organ when the stress of living arouses his psychodynamic
conflicts and he is no longer able to defend against them. All three
factors-a vulnerable organ system, an underlying dynamic conflict, and a
precipitating life situation-interact to produce the disorder. As we saw earlier,
the essence of the personality constellation for an individual who will
develop peptic ulcer is conflict over dependent needs versus independent
self-assertion, and the hypertensive conflict involves the damming up of
anger toward others. Alexander postulates other conflicts for asthma, arthritis,
and skin disorders.
As we have seen, some evidence supports this theory: from the psychological
profile alone, researchers have been able to pick out which male patients
have hypertension and ulcer well beyond the level of chance. Further, both
gastric secretion and blood pressure elevation occur when the relevant
emotions are aroused in individuals who have ulcers and hypertension.
BERAVIORAL AND COGNITIVE MODELS
Theories that stem from behavioral and cognitive views hold that learning
or cognition produces psychosomatic disorders, and they emphasize the
stress side of diathesis-stress. The stress can be produced by conditioning,
cognitions, or by life events.
Conditioning
The conditioning view of psychosomatic disorders maintains that the
symptoms are a conditioned response acquired when a neutral stimulus was
paired with an unconditioned stimulus that produced the disorder. For example,
asthma has been conditioned in the laboratory:
A thirty-seven-year-old shop assistant suffered from severe bronchia lasthma that
could be reliably set off by house dust. In the laboratory, she was sprayed with an
aerosol having a neutral solvent; the aerosol was to be the conditioned stimulus.
Following beings prayed with the aerosol, she inhaled house dust (unconditioned
stimulus), and an asthma attack (unconditioned response) followed. Thereafter,
upon inhaling from the aerosol, asthma attacks ensued. (Dekker, Pelse, and
Groen, 1957)
Since individuals who suffer from asthma sometimes have attacks following
exposure to highly specific events, such as experiencing a family argument
or other emotional conflicts, this is an appealing model of psychosomatic
illness. It has, however, only been demonstrated under
limited laboratory conditions and only some patients can be so conditioned.
Cognitions and Psychosomatic Disorders
Could it be that specific thoughts set off physical symptoms? William Grace
and David Graham argue that an individual's perception of the world and
what he thinks about threat predicts what psychosomatic disorder will develop.
This argument antedates, but is wholly compatible with the cognitive
model of abnormality. Grace and Graham interviewed 128 patients with a
variety of diseases to find out what situations immediately preceded
the onset of the symptoms and how the individual perceived what was happening
to him. They found specific thoughts associated with specific illnesses.
For example, individuals with high blood pressure were in a state of constant
preparation to meet all threats, and when confronted with threat they
thought, "Nobody is ever going to beat me. I'm ready for everything." Table
12-2 lists other illnesses that have specific thoughts associated with them
(Grace and Graham, 1952).
The modern cognitive school has yet to put forward a more articulate, research-
supported view, but we expect to see such a view within this decade.
Life Events
The final behavioral theory of psychological influence on illness involves life
stressors. It holds that stressful life events set off disease. If our reaction to
stress makes us susceptible to physical disease, then frequent stressful life
events should correlate with frequent disease. In the early pioneering research
on this question, Thomas Holmes and Richard Rahe devised a life
events scale, the Social Readjustment Rating Scale, by having individuals
rank the amount of stress different life events would cause them. Based on
these rankings, Holmes and Rahe assigned a number to each stressful event.
Death of a spouse was the most stressful life event; divorce
and separation were near the top; taking a new job in the middle; holidays,
vacations, and minor violations of the law were considered the least stressful.
The more life events an individual experiences, the more likely is he or
she to get sick from a variety of disorders. For example, individuals who had
heart attacks had more total significant life events in the six months prior to
their heart attack than in the year before. Similarly, individuals who became
depressed had a larger number of life events, particularly losses,
than those who did not (Holmes and Rahe, 1967; Paykel, Meyers, Dienelt, Klerman,
Lindenthal, and Peffer, 1969; Theorell and Rahe, 1971).
Since the construction of the Social Readjustment Rating Scale, investigators
have taken a closer look at the nature of the life events themselves.
First of all, some of the life events listed by Holmes and Rahe could themselves
reflect the fact of ongoing illness. For example, an individual might be
forced to retire (item 10) because he had high blood pressure, as opposed to
getting high blood pressure as a consequence of retiring. Modern investigations
of life events now distinguish between events that are confounded with
illness and those that might contribute to it (Dohrenwend and Dohrenwend,
1974).
Second, some of the life events are positive entrances, such as item 25,
outstanding personal achievement, while others are negative exits, like item
1, the death of a spouse. Losses or exits seem to produce more problems than
do entrances (Paykel, 1974).
Third, the repetitive, daily hassles of life may be better predictors of illness
than the major life events in Table 12-3. Losing your wallet, a price rise in
the weekly food bill, and the breaking of a window may ultimately push
health around more than deaths, divorces, and pregnancies (Kanner,
Coyne, Schaefer, and Lazarus, 1981). That is, it may be the gradual chipping
away at an individual by stresses that wear him or her down to a point where
susceptibility to illness jumps dramatically.
CONTROLLABLE VERSUS UNCONTROLLABLE LIFE EVENTS.
Another development in life events research concerns control over one's life. Recall
that David Glass argued that a Type A's vigorous struggle to control threat
followed by profound helplessness in the face of an uncontrollable event
predisposes him to coronary disease. Glass predicts that it is not life events
in themselves but uncontrollable life events that precede heart attacks, especially
among Type A's. Thus, he differentiates between uncontrollable and
controllable life events. For example, he categorized death of a close family
member, death of a best friend, and being laid off from work as uncontrollable
losses, but divorce, separation, and changes in eating habits as controllable
life events (Dohrenwend and Martin, 1978).
Three groups of patients answered a life events Questionnaire based on the
Social Readjustment Rating Scale. One group was in the coronary care unit
following heart attack, a second group was in the general medical and psychiatric
ward for non-coronary illnesses, and a third group was healthy. As
expected, the patients hospitalized for heart attacks tended to be Type A's,
whereas the patients hospitalized for non-coronary illnesses tended to be
Type B's. The three groups did not differ on total number of life events in the
preceding year. What distinguished the hospitalized groups from the non
hospitalized group, however, was the number of uncontrollable life events.
Both the individuals who had had heart attacks and the individuals who had
been hospitalized for other illnesses experienced more helplessness-inducing
life events than did the healthy controls. Taken together, these results
indicate that a combination of being a Type A and experiencing uncontrollable
life events-as opposed to a large number of life events per se-may be
a formula for heart attack (Glass, 1977).
SUMMARY
1. Psychological factors can influence the course, and even the beginning,
of a physical illness. Psychosomatic disorders are defined as physical
illnesses whose course or onset can be influenced by such psychological factors.
2. Psychosomatic disorders can best be viewed within a diathesis-stress
model. In this view, psychosomatic disorder occurs when an individual is
both constitutionally vulnerable to a particular physical problem and experiences
life stress.
3. Peptic ulcers occur when the naturally secreted hydrochloric acid of
the stomach erodes the protective mucous membrane of the stomach or duodenum.
Emotional states, particularly anxiety, can cause an oversecretion
of hydrochloric acid in the stomach.
4. Conflict, unpredictable bad events, and uncontrollable bad events all
produce anxiety and may all contribute to the formation of peptic ulcers.
5. Hypertension, or high blood pressure, like ulcers, is produced both by
constitutional, genetically inherited tendencies to high blood pressure, and
by psychological factors.
6. The emotional states of anxiety and hostility both produce increases in
blood pressure in the laboratory and in real life. Such an increase in blood
pressure is part of the adaptive emergency reaction to threat. Ifan individual
engages in it for a large proportion of his or her life, chronic and dangerous
hypertension will result.
7. Individuals who hold jobs that require constant vigilance arid personality
types who chronically view the world as hostile and threatening (Type
A) may be prone to high blood pressure and be at greater risk for heart attack.
8. Severe high blood pressure should be treated by anti-hypertensive
medication, but biofeedback, transcendental meditation, and relaxation can
all reduce mild hypertension.
9. When a person perceives the environment as threatening, but rather
than mobilizing against the danger, gives up, sudden death may occur.
10. Biomedical, psychodynamic, behavioral, and cognitive models have
all shed light on the causes and treatment of psychosomatic disorder. All are
compatible with the diathesis-stress perspective.
11. The biomedical view emphasizes the "diathesis" of the diathesisstress
model, and it argues that genetic inheritance and vulnerability in a
specific organ contribute to psychosomatic disorders.
12. The psychodynamic view emphasizes the personality types in whom
underlying dynamic conflicts, a vulnerable organ system, and a precipitating
life situation interact to produce psychosomatic disorders.
13. The behavioral and cognitive views emphasize the "stress" of the
diathesis-stress model. They hold that the way individuals learn to cope with
threat, think about threat, and the actual stressful and uncontrollable life
events that they experience play the major role in the way psychological
factors cause and aggravate physical illness.
EMOTIONAL INTELLIGENCE THERAPY APPLIED TO PSYCHOSOMATIC DISORDERS HAS BEEN PROVEN SUCCESSFUL.
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For the Treatment method I recommend click here:
http://theliberatormethod.com/Welcome.html