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Subject Topic: Mind-body issues Post ReplyPost New Topic
 Mind-body issues
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Ilse Jordaan
Posted: 2009 February 18 at 5:05pm | IP Logged Quote Ilse Jordaan
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Mind-body medicine has become a special interest of mine after seeing so many patients with emotional problems related to a medical problem (with it either being the cause or the result). In almost all of my patients who present with emotional problems one can find a physical link and vice versa (eg. psychological stress relating to a migraine, iscaemic heart disease resulting in depression, etc.). Despite the emotional link, most people present with their symtoms to a doctor, who then often treats them medically/surgically. Why is it that so many medical practitioners do not make the link and do not refer their patients who are often clearly in psychological distress, to a psychologist? Often patients only consult a psychologist after many futile visits to their GP, or after being advised to take this route by a friend or colleague. Why would this be the case and why is there this divide between the medical and psychology professions? How do my colleagues feel about this?
 
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DavidvdW
Posted: 2009 February 19 at 9:05am | IP Logged Quote DavidvdW

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I think it's a complex issue.

There's a mind body split that general western culture takes so for granted. Also perhaps most people who present with physical symptoms may not be aware themselves that psychological factors are involved. Perhaps too the shere volume of patients seen by many doctors means that indepth building of a relationship with their patient is not always possible.

Perhaps also we tend to see and understand people who consult us in terms of our preferred ways of looking at the world and if this gives primacy to the physical then it is more likely that we will treat the physical.

On a more philosophical note there's maybe two ways of understanding this - one being a kind of bio-psycho-social model where physical, social and psychological factors interact with one another and a second being some understanding of bodymind. This second is the greater challenge I think - to develop a system of understanding that does not somehow rely on the distinction between body and mind.

Also I wonder how many psychologists engage in psychotherapy and talk about all manner of issues without paying attention to neurological factors for instance?
 
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Martin Smit
Posted: 2009 February 19 at 2:52pm | IP Logged Quote Martin Smit
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@ Ilse, I think there are a number of different issues in your post. The "simpler" one being GP's etc. not refering patients who are obviously in psychological distress. Why don't they? -> some potential reasons: inability to accurately recognise psychological distress, emotional distress being judged as a "lesser problem", distrust/lack of knowledge of psychology, patients not actually presenting with emotional distress (or downplaying it) to GP's, and lastly the option opened by David, namely that medically trained persons probably have a bias towards seeing the physical (as an explanation for everything else) - just like psychologists probably have a bias to see the psychological/emotional/metaphysical.

The spilt between medicine/psychology+body/mind is, as David pointed out, complex. It should be kept in mind that medicine/psychology have a vested interest in the split but that psychology is perhaps a bit more vulnerable . . psychology may therefore be contributing to the split to a greater extent than medicine?

 
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Jason
Posted: 2009 February 23 at 8:38pm | IP Logged Quote Jason

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Maybe it is like a game of Rugby.  You can't play fullback and hooker at the same time.  However, sometimes it certainly helps to know what the other player is/can/is meant to be doing.  It certainly won't help to treat your own players as the opposition and players shouldn't think they are the referee.... 


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Jason
Posted: 2009 February 23 at 10:09pm | IP Logged Quote Jason

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I try to avoid watching Oprah.  It gets too costly having to replace
the television set after I inevitably throw the nearest object at it,
halfway into the program. Nevertheless, apparently she interviewed
Jill Bolte, a neuro scientist who suffered a stroke and has written
the book "My stroke of Insight". I have only had the rare privilege
of a patient being able to articulate, in minute detail, her
experience of the actual event of the stroke. Jill Bolte does so in
the following video http://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight.html.
For a student of postmodern theory, working with clients post stroke
has been a useful reminder not to underestimate the medical/physical
reality to our mind body connection.


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Jason Ross
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Ilse Jordaan
Posted: 2009 February 26 at 2:11pm | IP Logged Quote Ilse Jordaan
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Yes, I too wonder how many psychologists ignore the physiological? Wouldn't it be great if we as doctors or psychologists can be trained in both dimensions, so that we could have some understanding of both aspects? E.g., when is medication the cure and when is it just a plaster? When is the cause physiological and when is it psychological (or both)? One tends to think the distinction is easy, but often is it quite the opposite. Psychosomatic disorders present physically but are generally psychological in origin. Schizophrenia presents "psychologically" but is mostly a psychiatric/medical disorder. We tend to treat people from our perspective. The problem probably comes in when we believe our way is the only way...
 
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