Symbolic diseases and "mindbody" co-emergence. A challenge for psychoneuroimmunology.
Physical diseases that appear to be symbolic somatic representations of patients' personal meanings or individual 'stories' continue to be reported in the medical literature. The identification of a symbolic disease requires a clinical focus upon a patient's highly individual and nuanced meanings largely rendered invisible by the usual methodologies of clinical and research medicine, which has no coherent model for understanding symbolic disease. Therefore, a model is proposed of co-emergence of physicality and subjectivity, body and mind, disease and meaning, disease and symbol, which does provide a coherent basis for understanding symbolic disease. The 'mindbody' co-emergence model avoids mind and body dualism, assumes unbroken continuity between internal body processes and external interpersonal meanings and influences, and asserts that disease-related 'internal' bodily changes and collateral external interpersonal and environmental fluxes are mutually contingent and crucial to the development of the disease. The co-emergence model is discussed specifically in relation to psychoneuroimmunology, but it has exciting clinical and research implications for the whole of medicine.
Department of Immunology, Auckland City Hospital, Auckland University of Technology, Auckland, New Zealand. bandabroom@xtra.co.nz
Brian C
BC
Broom
Roger J
RJ
Booth
Christian
C
Schubert
D032882:Comprehension; D006801:Humans; D019222:Mind-Body Relations, Metaphysical; D008954:Models, Biological; D033262:Narration; D011598:Psychoneuroimmunology; D011602:Psychophysiologic Disorders / Q000523:psychology; D013001:Somatoform Disorders / Q000523:psychology; D013561:Symbolism