Psychosomatic Phenomena Research Articles

The Real 'Hard Problem' of Consciousness: Where Do Thoughts Come From, if Not the Brain?

This article argues that contemporary debates of the 'hard problem' of consciousness (i.e.how does 'mindless' matter produce 'matterless' mind?) cannot be resolved through philosophical analysis alone and need to be anchored to a comprehensive empirical foundation that includes psychophysiological research of psychosomatic phenomena and exceptional human experience. First, alternative perspectives on the mind–matter question and reasons why traditional formulations of the 'hard problem' have been so difficult to resolve are reviewed. Empirical evidence of mind modulation of bodily systems and its implications for the classical quantitative–qualitative distinction and construct of causal closure are then considered. A novel theory that combines bottom-up (panpsychism) and top-down (non-theistic panenpsychism) approaches relating physical processes to mental activity is then proposed that has practical implications for conceiving and exploring alternatives to current ways of thinking about the mind–matter question.

Cancer Doesn't Know the Day of the Week: Temporal Trends in Day of Death.

Studies support the existence of psychosomatic phenomena that enable critically ill patients to postpone death until a specific event. We assessed for this effect in cancer by examining variability in deaths at the month and weekend levels using the National Center for Health Statistics database. We found that deaths from cancer were not uniformly distributed temporally. There was a relative 3.3% difference death rate between the peak on Saturday and nadir on Monday, and relative 10.2% difference in rate of death between the peak of deaths in January and nadir in February. The "weekend effect" could be present in 1 in 200 cancer deaths and the "holiday effect" in 1 in 100 cancer deaths. Temporal variation may reflect a small portion of patients are able to "hold on" for a limited amount of time. This uneven distribution of cancer deaths highlights the importance of improving communication and facilitating end-of-life discussions.

Psychosomatic aspects in otorhinolaryngology-historical milestones

This investigation examined the development of psychosomatics in the field of otolaryngology in Germany using the examples of psychogenic deafness and chronic tinnitus by means of literature research. The focus of the study was on the period 1948-2022. Aliterature search was carried out in the PubMed database from 1948 and antiquarian ENT textbooks were evaluated. The search terms used were "ENT and psychosomatics," "tinnitus," "retraining therapy," "analytical psychology," "behavioral therapy," and "sensory systems." Psychosomatic phenomena were mentioned in the treatment of nasal diseases and ear ailments in writings of Byzantine and medieval medicine. Even older are references to tinnitus in ancient Egyptian and Indian scripts. From the nineteenth to the mid-twentieth century, psychological abnormalities in ENT symptoms were assigned to the term hysteria. From the middle of the twentieth century, aparadigm shift in the assessment of psychosomatic disorders in otolaryngology became apparent. In the 1950s, abroad psychosomatic discussion was opened in individual lectures and book contributions on mental abnormalities in ENT diseases. With the implementation of the Psychosomatics Working Group of the German Society of Otorhinolaryngology, Head and Neck Surgery, psychosomatics in the field of ENT received the framework for scientific and clinical activity at the turn of the millennium. Psychosomatics is scientifically represented and part of the continuing education regulations for otolaryngology in Germany and at European level. It shows high standards in research, qualification of otolaryngologists, and patient care. As of 2022, psychosomatics in otolaryngology has been steadily developing for over 70years. The standards achieved are to be further expanded and research on cognition, affectivity, and sensory analogies intensified.

Manasika bhavas and roga - A biopsychosocial model

Ayurveda reiterates the relationship between the body and mind in its approach to health as well as illness. Though the vitiated doshas, dhatus and malas remain the physiological basis of illness, the illness itself is a more complex psychosomatic phenomenon. Ayurveda has followed biopsychosomatic approach where more emphasis is given to the aspect of integration body and mind. In somatic diseases the psychological aspect cannot be neglected, similarly in psychological diseases somatic affairs are given due consideration. Social factors also play a major role in the inter relationships, financial support etc. Modern medicine accepted the biopsychosocial approach towards health recently. 
 Manasika bhavas mentioned in Ayurveda such as bhaya, krodha, soka etc., can cause or aggravate several diseases and hence there is a relation between these bhavas and roga. These manasika bhavas act as stressors as it become the cause of several diseases. Body’s response to stress has been widely studied in the branch of Psychoneuroimmunology. Recent research suggests that the mind and body share bidirectional influences, and the science of Psychoneuroimmunology identifies specific mechanisms by which these mind-body changes are mediated. Hence it is important to consider psychological factors along with biological and social factors in all diseases, assess and identify them in a timely manner so as to have effective management.

Cancer doesn’t know what day of the week it is: Temporal trends in day of death, 2000-2017.

12033 Background: Improving end-of-life care is an opportunity to reduce trauma for both patients and caregivers. Studies support the existence of a psychosomatic phenomenon known as the “holiday effect,” allowing critically ill patients to enter a bargaining phase and postpone death until a given event. We hypothesized that there may be a temporal trend as patients with cancer attempt to delay death until the arrival of family on weekends or the passage of a holiday. Methods: All deaths due to malignant neoplasms (ICD C00-C97) from 2000-2017 were collected from the National Center for Health Statistics. Outcomes were the days of week and months of year that death occurred. Weekend mortality was defined as death on Friday, Saturday, or Sunday. Holiday mortality was defined as death in December or January. Chi-squared tests were performed to determine differences in deaths by day or month. Logistic regression examined associations between day or month of death and age, education, race/ethnicity, location of death, marital status, race, and sex. Statistical analyses were performed using SAS statistical software, version 9.4 (SAS Institute Inc). Results: 10,305,990 deaths due to cancer were recorded from 2000-2017. Deaths were not uniform across day of week or month of year (p < 0.001 each). Each year, rates of death increased progressively from Monday to Thursday, peaked on Friday and Saturday, and declined on Sunday. There was a relative 3.4% difference in death rate between the peak on Friday and nadir of deaths on Monday. Each year there was a consistent increase in deaths in December and January, with a nadir in February with a relative difference of 10.2%. Multivariate logistic regression assessed associations in weekend and holiday cancer death. Non-hospital death (home, nursing facility, hospice) was more likely to occur on the weekend (aOR from 1.03-1.05, p≤0.01 for all). Hispanic patients (aOR 1.01, p = 0.001) were more likely to die on weekends. Females (aOR 0.99, p = 0.02), those who were divorced (aOR 0.99, p = 0.04) and those with pancreatic cancer (aOR 0.99, p = 0.01) were less likely to die on weekends. Non-hospital death was less likely to occur on Holiday months (aOR from 0.95-0.96, p≤0.01 for all). Those > 75 were more likely to pass away in Holiday months compared to younger age groups (OR 1.02-1.03, p < 0.05 for both). Cancer type was associated with holiday mortality; those with breast or prostate cancer were more likely to pass away (OR 1.01, p < 0.05 for both) during the holidays compared to those with lung cancer. Conclusions: There is a human element to death. The unequal distributions of deaths due to cancer in this study are small but significant; they suggest a non-biological variation that precludes cancer mortality from being strictly date agnostic. Temporal trends in cancer death highlight an opportunity to improve end of life care and demonstrate how care should shift focus to what matters to patients including time with family.

‘A transverse scar on the neck’ – psychosomatic approach in the differential diagnosis and surgical treatment of hyperthyroidism in post-war Finland

AbstractIn the Finnish medical discussion during the middle decades of the twentieth century, the challenging differential diagnostics between hyperthyroidism and various neuroses was perceived to yield a risk of unnecessary surgical interventions of psychiatric patients. In 1963, the Finnish surgeon Erkki Saarenmaa claimed that ‘the most significant mark of a neurotic was a transverse scar on the neck’, a result of an unnecessary thyroid surgery. The utterance was connected to the complex nature of thyroid diseases, which seemed to be to ‘a great extent psychosomatic’. Setting forth from this statement, the article aims to decipher the connection between hyperthyroidism, unnecessary surgical treatment and the psychosomatic approach in Finnish medicine. Utilising a wide variety of published medical research and discussion in specialist journals, the article examines the theoretical debate around troublesome diagnostics of functional complaints. It focuses on the introduction of new medical ideas, namely the concepts of ‘psychosomatics’ and ‘stress’. In the process, the article aims to unveil a definition of psychosomatic illness that places it on a continuum between psychological and somatic illness. That psychosomatic approach creates a space with interpretative potential can be applied to the historiography of psychosomatic phenomena more generally. Further inquiry into the intersections of surgery and psychosomatics would enrich both historiographies. It is also argued that the historical study of psychosomatic syndromes may become skewed, if the term ‘psychosomatic’ is from the outset taken to signify something that is all in the mind.

Vlad - Virtual Reality Application for Treatment of Psychosomatic Conditions: A report at final stage of software validation process

The present work aims to demonstrate that Virtual Reality (VR) can investigate several pathologies, in this case the treatment of all phenomena which interrupt the relationship between cognition and representation, such as defences in psycho-somatic phenomena.

O fora do corpo

As divergências entre fenômenos psicossomáticos e sintoma são esclarecidas na clínica a partir do conceito de holófrase, apresentado por Lacan durante o Seminário 11. Contudo, a holófrase já anunciava a ruptura com o simbólico, ao ser apresentada como significante real na condição de um S1 que não entra na cadeia. Isso nos permite dizer que a holófrase está fora do corpo simbólico. O problema se estabelece, sobretudo, na década de 1970, quando Lacan define o sintoma como letra, marcando Um que estaria fora do corpo. Seria a holófrase uma letra? A qual corpo se referia Lacan ao fazer essa constatação? Os avanços na teoria lacaniana ligados aos conceitos de corpo, de sintoma e de inconsciente implicam a necessidade de um estudo sobre os corpos e o que acomete o fenômeno psicossomático e o sintoma.

Psychosomatic Phenomenon According to the Stages of Development

The psychosomatic term, report to the item of psychological origin of certain organic diseases, affective repercussions of the state of physical disease on the individual and studies of mind-body relationships with emphasis on the explanation of somatic pathology. The term can also be understood, as an ideology about health, falling ill and about health practices, is a field of research on these facts and, at the same time, practice. Thus, the objective of this work is to discuss, from a literature review, the psychosomatic manifestations that occur in the development phases in the context of the psychology area. The study is methodologically based on the literature review. For this work, the bibliographic search of articles indexed to the VHL Portal (Virtual Library in Saude) and in the Web of Science was carried out. The disease is often an escape from a conflict situation or appears due to the need for attention and affection, need to be cared for. The psychosomatic approach decreases treatment time, avoids unnecessary complementary tests and abbreviates the patient's suffering.

МЕТОДИКА ДІАГНОСТИКИ ТІЛЕСНОГО ЛОКУСУ КОНТРОЛЮ

Метою дослідження було створення психодіагностичної методики для вивчення тілесного локусу контролю. Відповідно до мети дослідження завданнями роботи виступили: операціоналізація феномену тілесний локус контролю та його емпіричних індикаторів, розробка опитувальника як набору тверджень, що відображують зміст визначених індикаторів, психометрична оцінка, розробленого опитувальника. Методи дослідження. Психометрична обробка результатів дослідження включалаперевірку внутрішньої узгодженості методики за коефіцієнтом альфа Кронбаха, оцінку конструктивної валідності та ретестової надійності опитувальника. Конвергентна та дискримінативна валідність методики перевірялась шляхом визначення кореляційних зв’язків показників методики «Тілесний локус контролю» та методик діагностики ставлення до свого тіла О.Б.Станковської, діагностики локусу контроля Дж. Роттера, діагностики рівня суб’єктивного контролю Є. Ф. Бажина, С. А. Голикіної, А. М. Еткінда, опитувальника Body Awareness Questionnaire (конвергентна валідність); діагностики інтрацептивної чутливості, «Вербалізація тілесного Я» (дискримінантна валідність). Психометричну вибірку склали 286 «умовно здорових» респондентів віком від 15 до 55 років. Процедура ретестування проводилася через чотири тижні із залученням 96 респондентів, що входили до психометричної вибірки. Результати. Теоретичною основою створення опитувальника діагностики тілесного локусу контролю були концепція локусу контролю, концепції реципрокного детермінізму та каузальної атрибуції, уявлення про профіль суб’єктивного контролю, уявлення про роль інтернальності у клініці соматичних та психосоматичних розладів, а також зв’язку тілесного досвіду та смислового аспекту особистості, визначення локусу тілесного контролю, як зв’язку локалізації тілесних відчуттів із усвідомленням власного психоемоційного стану та ступенем самоконтролю, визначення основних сфер ставлення до тілесного, як ідентифікаторів тілесного локусу контролю. Шляхом деревовидної кластерізації було виділено статистично значущі класи тверджень, що відповідають 5 сферам ставлення до тілесного: сфера здоров’я і хвороби; сфера краси і зовнішності; сфера харчової поведінки; сфера сексуальної поведінки; сфера фізичної активності і спорту. Опитувальник характеризується інтраіндивідуальною стійкістю та розподілом близьким до нормального, що дає підстави для перенесення отриманих результатів вибіркової сукупності на генеральну, високою внутрішньою узгодженістю, . Визначені три інтервали граничні значення статистичної норми, що характеризують високий, середній та низький рівні показника інтернальності тілесного локусу контролю. Показники конвергентної та дискримінативної валідності свідчать, що запропонована методика вимірює саме усвідомлення детермінації особливостей функціонування власного тіла та характеризують приписування внутрішніх або зовнішніх причин того, що відбувається з тілом. Висновки. Запропонована психодіагностична методика «Тілесний локус контролю» відповідає сучасним вимогам до психометричного обґрунтування особистісних опитувальників. Психометричними ідентифікаторами тілесного локусу контролю визначено ставлення до основних сфер тілесного – сфери здоров’я і хвороби; краси і зовнішності, харчової та сексуальної поведінки, фізичної активності і спорту. Стандартизація опитувальника показала його високу тест-ретестову надійність та валідність. Опитувальник може бути використаний для психодіагностики у структурі досліджень з психосоматичної проблематики та реалізації оздоровчих психотехнологій.

Unexplained ocular and visual symptoms: The need for a psychosomatic approach in Ophthalmology

Abstract Introduction Psychogenic causes for some somatic symptoms have been widely recognised. In Ophthalmology however, there are few studies that address this issue, and current Ophthalmology Training Programs do not include formal teaching in Psychosomatics. Psychosomatic phenomena in ophthalmology are probably under-diagnosed, which may reduce therapeutic effectiveness, decrease patient and physician satisfaction, and increase health costs due to multiple consultations and prescriptions. The aims of this study were to describe patients with unexplained visual/ocular symptoms (UVOS), and to estimate the prevalence of psychological distress (PD) among them. Materials and methods Consecutive adults with UVOS were recruited over a 12 month period. Complete medical history and ocular examination were performed to rule out organic disease. Psychological Distress was defined by the presence of one or more of the following criteria: psychiatric diagnosis, use of psychotropic medication, psychosomatic disease in other organs, and biographical crisis in the last 6 months. Results were compared with a control group. Results A total of 39 cases of UVOS were recruited, corresponding approximately to 3% prevalence. The large majority (74%) were female. The mean age was 41.8 years. The most common complaints were ocular surface irritation symptoms (51%) and unspecific visual disturbances (17%). At least 1 of the PD criteria was found in 100%, including 46.2% with psychiatric comorbidity, 48.7% with psychotropic medications, 64% with psychosomatic disease in other organs, and 48.7% with recent life-stressful events. PD indicators were statistically higher compared with control group (P Conclusions There was a high frequency of Psychological Distress indicators in patients with UVOS. Although the causative role of PD remains unclear, the presence of UVOS should warn the ophthalmologist of an underlying psychic conflict and to make an appropriate psychological intervention.

THE CHARACTERISTICS OF BODILY-SELF DEVELOPMENT AT PRIMARY SCHOOLCHILDREN IN THE CONTEXT OF FAMILY RELATIONS

The article focuses on development of children’s bodily-self at the primary school age. The children’s bodily-self components are analyses in relation with their psychological distance to their parents. We used the following set of psychodiagnostic techniques: «The bodily-self verbalization», «Child's body image perception» and «Family sociogram». The central tendency, correlations and cluster analysis were used as the methods of statistical analysis. Conceptually, our study is based on the psychosomatic phenomena of normal functioning as they were described in the works of T. B. Khomulenko. The bodily-self is a multidimensional phenomenon, caused by factors of the exogenous and endogenous origin. The components of bodily-self are: emotional-evaluative, cognitive, behavioural and worldview. We are convinced that bodily-self have manifested on the level of being, which in turn, can be conscious or unconscious. The links between the structural components of the bodily-self exist at the level of self-control, psychosomatic competence (internal dialogue), sanogenic thinking and coping mechanisms. The bodily-self is regarded as a component of self-concept (in line with social self, spiritual self, culture self, physically self) and is responsible for the cognitive and emotional support of bodily functioning; it ensures regulatory effects, implemented during an internal dialogue about the body with the bodily-self, with oneself. There is no significant difference for children between psychological influence of their fathers and mothers, but father's body shape influences more strongly on the development of general index obtained with the used techniques set, and mothers influence more strongly on self-esteem of their children. If a father and a mother influence equally on their children's bodily-self development, the father is in the priority, this fact is characteristic also for adolescence. The relations between children and their bodily-self is quite strong, but due to age, children are not able to take care of themselves in full. Therefore, not all examined indicators are manifested to the same degree.

Síntomas visuales y oculares sin causa: La necesidad de un enfoque psicosomático en oftalmología

IntroductionPsychogenic causes for some somatic symptoms have been widely recognised. In Ophthalmology however, there are few studies that address this issue, and current Ophthalmology Training Programs do not include formal teaching in Psychosomatics. Psychosomatic phenomena in ophthalmology are probably under-diagnosed, which may reduce therapeutic effectiveness, decrease patient and physician satisfaction, and increase health costs due to multiple consultations and prescriptions. The aims of this study were to describe patients with unexplained visual/ocular symptoms (UVOS), and to estimate the prevalence of psychological distress (PD) among them. Materials and methodsConsecutive adults with UVOS were recruited over a 12 month period. Complete medical history and ocular examination were performed to rule out organic disease. Psychological Distress was defined by the presence of one or more of the following criteria: psychiatric diagnosis, use of psychotropic medication, psychosomatic disease in other organs, and biographical crisis in the last 6 months. Results were compared with a control group. ResultsA total of 39 cases of UVOS were recruited, corresponding approximately to 3% prevalence. The large majority (74%) were female. The mean age was 41.8 years. The most common complaints were ocular surface irritation symptoms (51%) and unspecific visual disturbances (17%). At least 1 of the PD criteria was found in 100%, including 46.2% with psychiatric comorbidity, 48.7% with psychotropic medications, 64% with psychosomatic disease in other organs, and 48.7% with recent life-stressful events. PD indicators were statistically higher compared with control group (P<.05). ConclusionesThere was a high frequency of PD indicators in patients with UVOS. Although the causative role of PD remains unclear, the presence of UVOS should warn the ophthalmologist of an underlying psychic conflict and to make an appropriate psychological intervention.

Emotional Suppression and Oneiric Expression in Psychosomatic Disorders: Early Manifestations in Emerging Adulthood and Young Patients.

BackgroundThe function of emotions, beginning from the proto-emotions, is the adaptation to the environment. This is based on the Homeorhesis, the equilibrium due to the adaptive operation of excitement and the dissipation of emotions. The object relations of the participants foresee the practice of defense mechanisms in a continuum that goes from the consciousness to the oneiric activities. The predominant and maladaptive use of defense mechanisms in the psychosomatic phenomenology, can be identified with deficits in emotional awareness, with the impossibility to manage excitement and dissipation of emotions foreseen by the oneiric phenomena.MethodsThe observation group is composed by 140 participants, 56 males (43%) and 84 females (57%),with pathological-functional disorders of psychosomatic domain. The study had been conducted with the use of measures related to the conscious defense of suppression (Suppression Mental Questionnaire), to the emotional awareness linked to the psychosomatic phenomena (Diagnostic Criteria for Psychosomatic Research Structured Interview-DCPR-SI) and to the states of perturbation and conservation of oneiric activities (The Manheim Dream Questionnaire-MADRE).ResultsSignificant inverse correlations emerged among rationalization, repressive function and illness Denial, as for the suppression mental questionnaire factors and irritable mood, but for Regression in the service of the Ego; inverse and significant correlations emerged among suppression, repressive function, rationalization and gastrointestinal psychosomatic outcomes and among suppression, repression and cardiological psychosomatic outcomes. Regarding alexithymia, a positive correlation emerged with rationalization and inverse with Regression in the service of the Ego. Positive correlations emerged between illness denial and overall emotional tone, for disease phobia and meaningfulness and for cardiological psychosomatic outcomes and nightmare distress and recurring nightmares.ConclusionThe study of such outcomes due to a prevalent defensive style based on suppression, suggest the identification of a key phenomenon, which translates into maladjustment that goes from functional disorders to parasomnia. The bridge established by the obfuscation of conscious contents until the manifestations of disturbance of ancient activities such as oneiric ones, expresses the need to transform an emotional maladaptive style, in line with classic literature and the current state of art.

The Suitability of a Transcultural Clinical Approach to Psychosomatic Disturbances in Reunion Island

Abstract Cultural foundations, beliefs and associated ritual practices delimit the relation to and the representation and lived experience of the body in specific ways. Language is the means through which the cultural specificity of both individual and shared mental content can be explored and worked with in therapy. This article presents beliefs about the body in a patient’s religion of origin and takes up the question of the role of the cultural dimension in psychosomatic phenomena. A case report gives indications of a novel therapeutic approach to this theme and highlights the intrinsic connection between cultural belonging and embodiment. Both the two-year long clinical intervention and analysis are grounded in transcultural and psychodynamic theories. The analysis shows how important it is to be aware of the patients’ cultural background and the resonance of history in the patients’ civilization.

Trouble sévère du sommeil à l’adolescence : réflexions théorico-cliniques

In the adolescence, period of the existence in the course of which the physical and psychic modifications are considerable, it is hardly always easy to be able to put into words apprehensions and incomprehensions. The body can then serve as vector, even release of the unspeakable connected in the multiple new and potentially stressful experiences, which the teenager realizes. It is frequent that we speak about psychosomatic phenomena when the demonstrations of the body and the spirit are confidentially connected. One of the possible expressions presented to the adolescence consists in the diverse modalities of the disturbances of the sleep. After a brief reminder of sleeping disorders in the adolescence and their understanding, we shall evoke a clinical label to develop a reflection on some marks at the level of the therapeutic support. It is from our experience within a unit of psychiatry of connection in a general hospital that we shall discuss an original model of pedopsychiatric care psychosomatic phenomena.

Pesquisa psicanalítica sobre os fenômenos psicossomáticos

RESUMO Lacan abordou os fenômenos psicossomáticos através do conceito de significante congelado. Os autores que se inspiraram nele fizeram uso desse conceito de diversas maneiras. Existem diferenças entre esses autores quanto à possibilidade de uma determinação concreta de tais significantes congelados (holófrases) que seriam suscetíveis de serem enfatizados pelo analista. Segundo alguns desses autores, o enfatizar tais significantes poderia colocar fim aos fenômenos psicossomáticos. Outros autores lacanianos contestam o valor clínico desse tipo de intervenção. O autor questiona também o parentesco entre os fenômenos psicossomáticos e outros fenômenos clínicos como a alucinação, a emoção, o humor e a passagem ao ato.

Key aims of the special series "the meaning of behavioral medicine in the psychosomatic field".

The practice of psychosomatic medicine is closely related to that of behavioral medicine, particularly in terms of the bio-psycho-social aspect of health, as has been demonstrated in the previous articles of BioPsychoSocial Medicine [1–3]. Behavioral medicine is an interdisciplinary field combining medicine, psychology and social science, and the integration of behavioral medicine with psychosomatic medicine would contribute to the understanding of psychosomatic phenomena in terms of treatment and the prevention of disease [4]. Such integration has been gradually achieved in fields of research and clinical practice during recent 50 years, but not yet satisfactory in terms of research and clinical practice. For example, among the major psychosomatic medicine journals, the percentage of articles focusing on behavioral medicine [MeSH] was estimated by a PubMed search in September 2015, and the results were as follows; 4.5 % (=212/4706) for “Psychosomatic Medicine”, 3.7 % (=164/4388) for “Psychosomatics”, 2.9 % (=129/4488) for “Journal of Psychosomatic Research”, and 2.2 % (=60/2768) for =2.2 %. It was 8.8 % (=16/181) for this journal, “BioPsychoSocial Medicine”, which was launched in 2007. In the same way, the percentage of articles focusing on psychosomatic OR mind/body [text word] was estimated for the major behavioral medicine journals, and the results were as follows; 2.3 % (=12/531) for “Behavioral Medicine”, 1.3 % (=11/856) for “International Journal of Behavioral Medicine”, and 0.7 % (=12/1626) for Journal of Behavioral Medicine. The percentages were smaller than those of the psychosomatic medicine journals. These figures mean that it is necessary for specialists engaging in psychosomatic medicine not only to sharpen their own research into behavioral medicine but also to broaden their findings toward specialists in behavioral medicine. Psychosomatic medicine encompasses all aspects of the interrelationships between the biological, psychological, social, and behavioral factors of health and illness, and is not limited to mind and body connections in humans. Thus, it is meaningful that behavioral and social aspects of health and illness are discussed in the current issue of this journal [1]. In Japan, a total of 80 medical schools exist, and curriculums for medical students have been changed in accordance with international standards. In the revised curriculums, aspects of behavioral and social sciences must be included and it is a great chance to facilitate behavioral medicine. In these circumstances, the Japanese Society of Behavioral Medicine established a working group to develop a core curriculum for behavioral medicine and has discussed the clinical, psychological, and public health aspects of behavioral medicine. Specifically, two purposes are intended in this special series. The first is to summarize the behavioral and social aspects of health and illness in the psychosomatic filed in order to achieve full cooperation among different specialists in terms of prevention and treatment of psychosomatic illnesses as well as promotion of mind/body health. The second is to emphasize the importance of education on behavioral medicine, exemplified by the establishment of a core curriculum for behavioral medicine in Japanese medical schools.

Pain as a Conversion Symptom or a Psychosomatic Phenomenon: Fake or Real?

According to the psychoanalytical Freudian approach, the pain in a conversion symptom (hysterical pain), whether defined or indefinable, corresponds to a displacement of the intrapsychic conflict to the subject’s physical body. The libidinal energy attached to the repressed representation is transformed into neurotic energy in organs or parts of the body so as to dramatically represent the desirable as well as the prohibitive. The body lends itself as a ‘location’ to the conversion disorder in order for the anguish of the intrapsychic conflict to be expressed in openly manipulative terms. Does this hysterical pain designate both the pleasure of the performance and the discontent of the psychological anguish? On the contrary, the psychosomatic pain manifests itself in the actual physical body of the organism and not in the illusory body of the hysteric. It is possible for the (psycho)somatic disorder to be expressed through the pain symptom upon an existing, objective condition diagnosed in an organ or body part. But is it not the very nature of the psychosomatic disorder a unique differentiation criterion between the two types of the disorder? The rationale, the type of the psychological defense mechanisms and the nature of the impulsive dynamics which subdue each of those two types of painful symptoms constitute criteria of other differentiators within the psychopathological and psychoanalytic approach.

Distancing Disaster: Trauma, Medium, and Form in the Greco-Turkish War and Population Exchange

Recent work in trauma studies has begun to differentiate collective trauma from its individual counterpart: while the latter is a psychosomatic phenomenon, the former is a secondary product, mediated materially, temporally, socially, and linguistically. The collective trauma that emerged from the Greco-Turkish War and Population Exchange of 1919–1924 serves as an exemplary case in point. Looking in particular to literary production, I assess how the trauma narrative of 1919–1924 was “remediated” in two Greek novels. For much of the twentieth century, the field of Greek prose fiction was dominated by the formal regime of realism, which masked the mediations of textual production and promulgated instead a rhetorical logic of authentic and immediate historicity. Using Elias Venezis’s Το νούμερο 31328 (The number 31328) and Kosmas Politis’s Στου Χατζηφράγκου (In the Hadjifrangou neighborhood), I trace the formal strategies by which two particular trauma narratives reacted to this realist regime, developing a theory of the self-reflexive medium.