[Specificity models in psychosomatic medicine: review of an old controversy]

The assumption that specific factors of personality or unconscious conflict are causative factors in psychosomatic diseases was a guiding concept in psychosomatic medicine for a long time. An early paper of F. Alexander written in 1934 and a series of papers on the problem of specificity published in 1958 serve as examples to bring this important issue back to memory. The original problem seems to have been solved by exchanging specificity models by models of interaction of multiple factors and of multifactorial constellations. It is argued that the debate on specificity in psychosomatic medicine has implicitly been a debate on the scientific status of the psychoanalytic approach in psychosomatic medicine, and that these methodological issues are still vital to psychosomatic medicine.