Dimensions of abnormal illness behaviour.

Abstract

If the natural history of an illness were dependent for its characteristics only upon the nature of the pathological changes which underlay it, doctors would experience a professional existence of remarkable simplicity and predictability. We know full well, however, that such a state of affairs is incompatible with the nature of man, whose capacity for symbolic activity renders his every experience uniquely his own. While this fact has long been appreciated by many physicians, particularly as far as psychological disorders are concerned, it has taken longer for the non somatic dimensions of organic dysfunction, to receive the sort of systematic attention they so clearly deserve. This long-neglected “psychosocial dimension’’ of disease or, to be more precise, a particular facet of it, is the subject of my presentation today. As my title indicates, it is illness behaviour upon which I propose to focus my attention. The phenomenon of illness behaviour may be numbered amongst those whose ubiquity has rendered them virtually invisible. One may speculate, that in times when medical men were few and health care systems rudimentary, the many ways in which individuals reacted to bodily dysfunction, were of far less concern than the understanding of the pathological processes presented by those who were fortunate enough to actually reach medical assistance. Nonetheless, extreme reactions to bodily functioning were noted by physicians from the Hippocratic era onward, and not a few recorded cases of individuals who manifested pathological attitudes to their state of physical health.