Psychosomatics - A Holistic And Phenomenological-Existential Vision

 According to Brandão (2000), there are some misconceptions about the term ‘psychosomatic’.  Some believe that if a particular disease is considered to be psychosomatic, it means that it only exists in the patient's mind. Under the influence of psychoanalysis, others believe that the psychosomatic illness is caused by unconscious motives that are beyond the patient’s comprehension and are therefore out of his control.

       For the majority, however, the term ‘psychosomatic’ (psyche + soma) signals that a disease has been generated or is being aggravated by a psychological process underlying it. Within this line of reasoning, physicians of the Institute of Psychosomatic of Paris affirm that all disease is psychosomatic, since there is always the participation of the mind in any process of illness.

      Although this position represents a great advance in relation to the strictly organicist medicine, here remains remnants of the dichotomy body/mind, remnants that begin to dissolve with the discoveries of Neuroscience, which operates within another scientific paradigm - the holistic one.

      According to Crema (1989), paradigm (from Greek paradeigma) corresponds to a scheme of description, explanation and understanding of reality, shared by a community and capable of generating theories, influencing the learning process. It covers beliefs, values ​​and techniques.

      We will begin the exhibition showing the main conceptions of the Cartesian-Newtonian paradigm, still dominant in our culture, and its reflections on health. We will then move on to the holistic paradigm, pointing out the different views of the world, human being, health and illness introduced by this paradigm, which provide new foundations for the area of ​​psychosomatics, together with the recent discoveries of Neuroscience, which will then be examined.

      Finally, we will show how, in this new paradigm, the science of the West approaches the philosophical-religious traditions of the East and the basic assumptions of the North American psychologist Carl R. Rogers about the human beings and their functioning.

1. The Cartesian-Newtonian Paradigm:

As Capra (1989) pointed out, within this paradigm, the emphasis falls on structures and these are analyzed by reducing the whole to its constituent parts, by influence of the atomistic model of reality. The assumption is that the isolated analysis of the parts and the joining of them at the end in the whole lead to the knowledge of this whole.

      The causal model adopted is logical-linear causality, that is, event A causes event B, which, in turn, causes event C in a unidirectional sequence, always having a specific cause for a specific event. In this way everything is actually predetermined and will always occur in the same way.

According to Brandão (2018), if we observe the influence of this paradigm on health, we have that the disease is conceived as something external that attacks the organism, disorganizing it. The patient becomes a passive being, a patient (and how!), since he is not responsible for his illness or for his cure. The cure is the elimination of physical symptoms and, if there are no physical symptoms that can be observable, quantifiable or detected by images, there is no disease. The doctor, through a purely physical and focal intervention, will be responsible for the elimination or control of the disease.

Capra also highlights the fragmentation of academic teaching and the proliferation of medical specialties in ever smaller segments of the body, losing the perception of the person as an integrated whole.

2. The Holistic Paradigm:

In this new paradigm, the emphasis is on the processes, seeking to understand the different dynamic interconnections between the parts and those with the whole. In this way, the view of the whole is preserved and each totality is seen and understood in its uniqueness.

 Reality presents itself with several changes occurring simultaneously and continuously. And in this cosmic dance, nothing is predetermined. What exists are probabilities of events at some time and somewhere. The universe is constantly being created and recreating itself at several levels.

For Weil (2004), as a reflection of this new vision on health, the disease appears as the result of an imbalance and disharmony, which occurs first at the energy level of the organism and which then manifests itself at the physical level. The integration of the whole is affected.

Brandão (2018) emphasizes that the patient is here conceived and treated as an active being, responsible for his illness and for his cure, encouraged to act as an agent in the process of recovery and promotion of his health. The cure does not restrict itself to only physical symptoms and begins to demand changes in the whole person, involving his behavior, his attitudes and his feelings in relation to others, to himself and to life. Cure is thus linked to the evolution of human consciousness, and in this process, the doctor must rescue his Latin root (docere = to teach) and act as a facilitator of these changes in the client, together with other health professionals, in a transdisciplinary approach. 

3. The Systemic Conception:

Within the holistic paradigm, we have the systemic conception of life. In this conception, organisms are understood as self-regulating systems, presenting in their operation continuous, multiple and interdependent fluctuations. In humans, this conception leads to the recognition and appreciation of the body's internal healing mechanisms, encompassing repair and regeneration processes, as well as homeostasis and adaptation mechanisms.

Health is also conceived as a process of activity and continuous changes that develop as creative responses of the organism/person to the challenges that arise in relation to the environment, that is, health demands flexibility. The organism also presents two basic and complementary trends - self-affirmation and integration, with health corresponding to a balance between these two trends.

Weil (2004) emphasized that the words hale, heal, health, holy, holiness, and whole descend from the same Anglo-Saxon root meaning wholeness. In this way, medicine and religion seem to have the same purpose, which is to restore totality. Health represents body, mind and spirit functioning in an integrated way with each other and in relation to the environment. Health is wholeness and balance.

4. The Descartes’ Error:

The influence and effects of the Cartesian mind / body dichotomy in Western culture were well examined by Capra (1989).

Damásio (1996), a Portuguese neuroscientist, started from the studies of patients with lesions in the prefrontal lobe of the brain and concluded that the brain and the rest of the body form an indivisible organism. He emphasized the existence of two ways of bi-directional communication between the brain and the body: 1. The biochemical circuit, composed of hormones, neurotransmitters, and interleukins, among other substances circulating in the bloodstream, involving the endocrine, the immune and the nervous systems; 2. The neural circuit, formed by the autonomic nervous system (ANS) and the voluntary nervous system (VNS).

Damasio also overturned the dichotomy between reason and emotion, which have been associated with evolutionarily different structures of the brain. The most primitive structures - the brainstem, hypothalamus and limbic system, which make up the reptilian brain and the emotional brain - are related to the functioning of basic life processes (respiration, digestion, heartbeat, temperature, hydrosaline balance), to instincts linked to the preservation of the species (sexuality and aggression) and to the primary  emotions. The neocortex corresponds to the most evolved structure, responsible for rationality, involving the higher cognitive functions (thought, planning, intentional action, language, conscious will and control, perception, reasoning and intellectual memory).

Damásio concluded that the neocortical rationality of the human being did not develop or  it acts independently from the more primitive structures of the brain, linked to the emotions and the body, but that depends on these structures. On the other hand, he discovered that the emotion corresponds, in fact, to a process of mental evaluation, which starts from considerations in the frontal cortex, that activates the limbic system and this, in turn, sends messages to the autonomic nervous system, to the endocrine system and to the voluntary nervous system, generating an emotional state of the body. The limbic system also sends messages to the brain stem, influencing the regulation of the body, and then back to the cortex, affecting the efficiency of cognitive processes.

In other words, emotions involve and depend on cognitive processes, connecting mind and body, and affecting those processes. Thus, a negative emotional state of the body, such as depression, makes thinking slow and poor, and reasoning ineffective, whereas a positive emotional state of the body makes thinking become faster and richer, and reasoning , also fast, but not necessarily effective, as occurs in mania.

5. Neuroscience:

The discovery of receptors on the membranes of cells and ligands, substances that travel through the extracellular fluids and couple to their receptors, marked the existence of a parasynaptic circuit of communication, that is, outside the synapses, representing a second nervous system.

Pert (2003) and other neuroscientists, as they advanced their research, found that: 1. Ninety-five percent of the ligands are peptides, that is, chains of amino acids; 2. Each and every peptide is produced in many parts of the body; 3. Any peptide is potentially a neuropeptide, having receptors in all parts of the brain; 4. Acting as vehicles of this communication network, peptides are considered information molecules.

From the discovery of this second nervous system, circulating throughout the body, neuroscientists developed the concept of "mobile brain", corresponding the mind to a flow of information throughout the body. In this flow, which operates in a complexly orchestrated way, intelligence is found in cells, organs, and systems, pointing to the "body wisdom." Since neuropeptides and their receptors are not only in the brain, but throughout the body, we can say that the mind is in the body. And the body becomes the outer manifestation of the mind, or rather the body is the subconscious mind. In this way, we come to the concept of the "bodymind".

Pert underlines that neuropeptides and their receptors compose the biochemistry of emotions, transforming information into physical reality, mind into matter. Emotions unite, therefore, body and mind, being experienced by the whole organism, involving the whole being. In this sense, all emotions are healthy.

The repression and/or negation of emotions is that which causes a blockage or an insufficient flow of peptides, negatively interfering in the integrity of the system and, on the one hand, causing the collapse of the vital processes and damage in the internal mechanisms of healing of the organism, leading to the development of diseases. On the other hand, blockage or insufficient flow of peptides in the prefrontal cortex leads to a limitation of consciousness, conducting to a repetition of patterns of behavior and feelings.

6. The Philosophical-Religious Traditions of the East:

In his book, The Tao of Physics, Capra (1989) established a parallel between the recent discoveries of Quantum Physics and the millenary religious philosophies of the East, demonstrating a convergence in the world view and in the human being view between East and West , between religion and science. Crema (1989) represented this metaphorically as the two wings of a bird, both equally necessary, working together in synchrony so that the bird can fly. Again, we have wholeness and balance here.

6.1. Vedic Philosophy:

Intelligence is considered the basic force of nature, being part of the whole universe and being present in every cell of the human organism, regulating the essential functions through hormones, enzymes, antibodies, etc, corroborating the findings of Quantum Physics, Holistic Psychosomatic and Neuroscience.

Chopra (Brandão, 2000), director of the Maharishi Ayurveda Health Center in the USA, associating the mind with states of health and disease, signaled that positive states of mind cause chemical changes in the brain that have a beneficial effect on the body, whereas negative states of thought generate chemical changes harmful to the body. In this way, the ratio between the different neurotransmitters will depend on the state of mind exercised by the person in his day to day, and on the thoughts that he cultivates.

 Evolution corresponds to a process of life itself, operating at the biological level and at the level of the cosmos. In the case of the human being, this evolution also operates in his consciousness, so that it reaches the comprehension of the totality of life. Wisdom is not to interfere, but to indulge in this process and flow of intelligence. Disease arises as a consequence of the interruption of this flow. And health means an integrated and balanced functioning with this flow.

 This flow of intelligence operates in cycles and rhythms, which alternate, interpenetrate, and interact in and out of us, all part of the same cosmic dance - the dance of the god Shiva. And it is through transcendental meditation that the individual can get in touch with the quantum level of the universe and act at the quantum level also present in his body to balance his mind and consequently his body.

6.2. Chinese Philosophy:

Harmony of energy corresponds to the basic law of the universe, harmony between the two opposite and complementary forces (yin and yang) of the Ch'i energy, which generates the whole universe. These forces are expressed at all levels, alternating in cycles - expansion and contraction, rest and activity, day and night, summer and winter.

As Brandão (2000) pointed out, the human being is conceived as a replica of the universe, also in continuous movement, under the influence of the cycles of nature and his internal cycles, which generate changes in the quantity and distribution of energy in his body. The imbalance of the yin and yang forces produces the disease, and it is therefore necessary to restore the balance at this level to restore health.

The energy in the human being flows through twelve main channels, called meridians, which are associated with the main physical organs/functions, an emotion or feeling and a behavior or attitude in life, conceiving the influence of the emotions in the flow of energy and, consequently, in the physical body.

The disease begins with energy congestion in the meridians and, if not corrected at that level, develops into an observable clinical symptom - a change in function or injury. Health comprises not only the physical body, but also the mental, emotional and spiritual attitudes, depending on the harmony with the internal cycles of the organism and with the external cycles of the environment. Wisdom lies in recognizing these cycles and acting in accord with them. The concept of wuwei (non-action) actually means 'non-interference', but 'harmonious and integrated action with the flow of life'.

7. The Carl R. Rogers’ View:

7.1. The Holistic Theory of Kurt Goldstein:

       In developing his conception of a human being, Carl Rogers relied heavily on neurologist Kurt Goldstein's studies of World War I soldiers with brain injuries. Goldstein developed a holistic theory about the functioning of the organism, based on Gestalt theory. According to Lima (n.), he considers the human organism, the person, as a totality in interaction with the environment. Or, from a field perspective, he perceives the person as a subsystem within progressively broader systems.

       On the other hand, the organism itself is understood as a system formed of several subsystems, so that when a stimulus reaches a subsystem, it promotes changes in the organism as a whole, aiming for the equilibrium of the global system.

       This organization, unity and integration of the person are expressed through an inherent tendency to growth and through an organismic self-regulation. The actions necessary for the proper functioning of the organism emerge as needs to be updated in relation to the environment, while the organism has to deal with the demands of that environment. On these two aspects - internal needs and external demands - depends the dynamic balance of the organism.

       As emphasized by Votsmeier (1996), Goldstein considers the symptoms not as arising from certain lesions, but as responses of the organism as a totality to certain issues experienced by the person. In this way he wonders how the symptom is acting in the preservation of the organism and seeking a greater realization of that person in his or her uniqueness. This perspective emphasizes an adaptive function of the symptoms, allowing a deeper understanding of them.

       The tendency to self-realization is thus described as the basic motivation of every activity of the organism. And, as Lima (n.d.) points out, if the body's responses are contrary to this tendency, it is because the organism is in adverse operating conditions. At this point, Goldstein emphasizes the negative effects of anxiety on both the physical and mental aspects, destabilizing the functioning of the organism as a whole.

7.2. The Organismic Theory of Carl Rogers:

       According to Rogers (Gondra, 1981), the human organism is a Gestalt or organized configuration, reacting as a whole to reality, as it is experienced and perceived by it. Being a Gestalt, an organized system, the organism transcends the simple sum of its parts. And the modification of one part necessarily implies the change of the other parts and the whole, since the system is governed by the laws of intercommunication and the interdependence of the parts with each other and of them with the whole, in addition to being based on the principle of internal coherence.

       The term 'organism' goes beyond the traditional, medical conception which concerns only physical functions and tissues, to refer to the totality of the bodily and psychic aspects of the human being, aspects inexorably inseparable, interpenetrating and determining mutually. In this totality, the individual's experience - his feelings, thoughts and emotions - emerges as a highly significant element in determining his health, having a close relationship between the experience and the biochemistry of the organism.

For Rogers (1977), the world of experiences of the individual, the world of which he is the center and which is in constant change, comprises all that is experienced by the organism as a whole, whether these experiences are a record at the level of consciousness or not . This experiential field is the reality to which the organism reacts. Modifying the field, the behavior of the organism is modified, that is to say, not only its externally observable behavior, but also its physiological reactions.

The human organism has a driving system, called actualising tendency, the same directional force observed throughout organic life and in the universe itself. This trend encompasses not only the narrow notion of motivation, linked to the preservation of life through the satisfaction of needs and the reduction of tension, but also the expansion of the organism towards a continuous overcoming of its status quo and the expansion of its capacity to autonomous action. It presides over physical and experiential functions, that is, it guides the physical and psychic development of the human being, acting in its totality, seeking its conservation and its enrichment, according to the possibilities and limits of the environment, as they are perceived by the person, and according to the perception he has of himself.

Conclusion:

We are living the transition to a new scientific paradigm, based on the findings of Quantum Physics, which outlined a new view of reality, the holistic view, focused on the perception of totality and continuous processes of interdependent changes. This new view is having a profound impact on many areas of human knowledge. One such area is Neuroscience, which is dissolving the dualistic, Cartesian conception of humans, as having a separate mind from the body and, in the mind, separate reason from emotion. Neuroscience, then, speaks of 'bodymind', of 'mobile brain', as a dynamic and integrated network of information throughout the organism. It also speaks of 'body wisdom', where intelligence is present in every cell, organ and system of the organism. Reason and emotion are inexorably linked together and function interdependently in the behavior of the human being.

It becomes inevitable to make an association with the concepts of 'organism', 'actualising tendency' and 'organismic evaluation process', developed by C. Rogers in the 1940s, previously, therefore, to the emergence of the new paradigm. This association of the concepts of Neuroscience with Rogers’ concepts provides a confirmation and scientific support for the latter.

On the other hand, we see that the holistic view of the universe and the discoveries of Neuroscience go towards the monistic, totalizing view of the human being, which had already been present for millennia in the philosophical-religious traditions of the East and with which Rogers's conceptions is tuning.

It seems that ‘all paths go to Rome’.

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