Recently a doctor friend of mine asked me, “What is psychosomatic medicine?” When my answer was more vague than concrete, I realized clarification was in order.
Psychosomatic Medicine is a subspecialty of psychiatry. The American Board of Psychiatry and Neurology gives the following definition:
Subspecialization in the diagnosis and treatment of psychiatric disorders and symptoms in complex medically ill patients. This subspecialty includes treatment of patients with acute or chronic medical, neurological, obstetrical or surgical illness in which psychiatric illness is affecting their medical care and/or quality of life such as HIV infection, organ transplantation, heart disease, renal failure, cancer, stroke, traumatic brain injury, high risk pregnancy and COPD, among others. Patients also may be those who have a psychiatric disorder that is the direct consequence of a primary medical condition, or somatoform disorder or psychological factors affecting a general medical condition. Psychiatrists specializing in Psychosomatic Medicine provide consultation-liaison service in general medical hospitals, attend on medical psychiatry inpatient units, and provide collaborative care in primary care and other outpatient settings
I glazed over just trying to type this out. In a nutshell it’s medical psychiatry: the interaction of the mind and body in relation to the onset, process and progression of all diseases. It’s understanding and practicing a healthy mind, healthy environment and healthy personality mean physical health, mental health and well being. It is a holistic concept of disease management leading to mind and body wellness. I literally assess the psychological, neurological, endocrine and immune status of the individual. I assess the medical disease status of the individual. I understand personality, genetic and environmental factors that affect homeostasis or wellness. I evaluate and can improve patient function mentally and physically using evidence based medical treatment and psychotherapy techniques. The approach is integrative where the bio, medical, psycho and social aspects of wellness are considered. Psychosomatic medicine is the new field of integrative medicine.
As you can see the total person is evaluated; psychosomatic
medicine subspecialists leave nothing on the table.
|Total health and well being is where the 3 circles intersect.|
I spend most of my time with the above evaluations particularly in chronic pain management and addiction medicine. I am able to improve mental function and outcomes in the setting of medical complications such as drug withdrawal and detoxification. My treatments are aimed at achieving wellness without relapse. I minimize polypharmacy and lifelong medication use. Polypharmacy and lifelong medication is antithetical to the definition of psychosomatic medicine.
I know this definition seems long. One of my teenage patients said just call yourself an uber psychiatrist. I think I like that!