Psychogenesis of somatic disorders. An overview

Psychogenesis, considered as a linear sequential process by which psychological influences lead to somatic disturbances, is only a link in a larger bio-psycho-social interactional field. Therefore, in practice, a multilateral approach of the whole person, in his psychological, social and somatic aspects, in health and disease, in his habitual and his therapeutical contacts, should be stressed. it seems unlikely that the somatic symptoms we are confronted with can be considered as pure psychogenetically determined phenomena. This does not exclude that in the complex psychosomatic interaction, there exists at one or more stages a transition from the sphere of psychological functioning to the somatic area, ending up in somatic symptoms. This process, which we call psychogenesis, is not a single event but should be considered as an abstraction, grouping a number of component processes possibly occurring at different moments in the total system. We have distinguished four components: a psychopathological component, a psychophysiological component, a phychophysiological component, a physiopathological component and a 'somatic illness experience' component. For each of these components, a number of conceptions are proposed according to the different theoretical models of psychosomatic connections. Most of these formulations are largely hypothetical or based only on fragmentary observations. Still, they offer guidelines for further research.