psychosomatic research center psrc@mui.ac.ir هوالحکیم

Psychosomatic Research CenterPsychosomatic Research CenterPSRC@mui.ac.ir

هوالحکیم

Disease/Illness

Disease – biological event with pathology – disease as a specific entity

Illness – subjective experience – devalued changes

Disease does not exist as a social phenomenon until we agree it does, who labels this: Dr? Patient? Science?

Diseaseillness

Doctor’s viewPatient’s view

More objectiveMore subjective

GeneralizedIndividualized

AbstractConcrete

CategoricalNarrative

BiomedicalBio-psychosocial

Rational/ ExperimentalPhenomenological

Disease Vs. IllnessDisease Vs. Illness

A medical model which is based on multilevel A medical model which is based on multilevel

interactions, from molecule to society.interactions, from molecule to society.

Multilevel assessment/ interventionMultilevel assessment/ intervention

The scope of psychosomatic medicine?The scope of psychosomatic medicine?

Person – centered not disease - orientedPerson – centered not disease - oriented

Psychosomatic Approach toPsychosomatic Approach to Disease & Illness Disease & Illness

Thoughts & Images

Physiology (Central Chemistry)Emotions

Behaviour

Cognitive Model

Environment

Triggersstress, distress, anxiety, illness, symptoms

Physical symptoms

Meaning/interpretationThreat, loss, inability to cope

Emotional responseAnxietyDepression

Behaviour: rest, checking, reassurance seeking,

medication, treatments

Cognitive Model of Somatisation

Probability x (perceived cost) awfulness

Anxiety =Perceived ability to cope + chance of help (rescue)

Cognitive behavioural approachto understanding health anxiety

Factors involved in the maintenance of health anxiety

Physiological & biologicalSymptoms

Bodily variationsMedical information

(Selective attention)(Arousal)

Beliefs about being ill

•Probability•Cost•Coping•RescueReassurance

seeking,Checking, safety behaviours

Mood changes• anxiety• depression

(Prevent disconfirmation) (Alters perception)

Approach to patients: Approach to patients: disease or illness orienteddisease or illness oriented? ?

Ideas, BeliefsIdeas, Beliefs Cognitive styles Cognitive styles EmotionEmotion FunctionFunction ExpectationExpectation Concerns, questionsConcerns, questions

What is sick roleWhat is sick role??

The protective role given an individual who is physically or mentally ill or injured; it may be assumed by the individual or it may be imposed as a part of social

custom.

A behavior pattern in which a person adopts the symptoms of a physical or mental disorder to be cared for, sympathized with, and protected from the demands and stresses of life.