Further reflections on psychosomatic theory. Alexithymia and interhemispheric specialization

Area of Science:

• Neuroscience
• Psychosomatic Medicine
• Psychiatry

Background:

• Alexithymia is traditionally explained by psychodynamic theories.
• Clinical observations suggest a neurophysiologic basis for alexithymia and psychosomatic processes.
• Existing data support a functional disconnection between the cerebral hemispheres in alexithymia.

Purpose of the Study:

• To present a neurophysiologic hypothesis for alexithymia.
• To explain psychosomatic processes through a proposed brain disconnection mechanism.
• To link the inability to process painful stimuli to psychosomatic illness.

Main Methods:

• Review of clinical and laboratory observations of alexithymia.
• Application of Kaplan and Wogan's experimental analogue of alexithymia.
• Development of a hypothetical mechanism for interhemispheric functional disconnection.

Main Results:

• A functional disconnection between cerebral hemispheres is supported by current data.
• A proposed mechanism implicates impaired right hemispheric processing of painful stimuli.
• This mechanism offers an explanation for observed psychosomatic illnesses.

Conclusions:

• A neurophysiologic hypothesis, specifically interhemispheric disconnection, provides a useful framework for understanding alexithymia and psychosomatic disorders.
• The proposed mechanism highlights the role of impaired emotional processing in psychosomatic illness.
• Further research is needed to elucidate and test this neurophysiologic model.