Bakal D, Steiert M, Coll P, Schaefer J
Clinic for Mind-Body Medicine, Calgary Health Region and Department of Medicine, University of Calgary, Rockyview General Hospital, 7007 - 14th Street S.W., Calgary, Alta., Canada T2V 1P9.
Med Hypotheses. 2006;67(6):1443-7. doi: 10.1016/j.mehy.2006.05.028. Epub 2006 Jul 11.
This article outlines an experiential mind-body framework for understanding and treating patients with medically unexplained symptoms. The model relies on somatic awareness, a normal part of consciousness, to resolve the mind-body dualism inherent in conventional multidisciplinary approaches. Somatic awareness represents a guiding healing heuristic which allows for a linear treatment application of the biopsychosocial model. The heuristic acknowledges the validity of the patient's physical symptoms and identifies psychological and social factors needed for the healing process. Somatic awareness is used to direct changes in coping styles, illness beliefs, medication dependence and personal dynamics that are necessary to achieve symptom control. The mind-body concept is consistent with and supported by neurobiological models which draw on central nervous system mechanisms to explain medically unexplained symptoms. The concept is also supported by a recent hypothesis concerning the role peripheral connective tissue may play in influencing illness and well-being. Finally, somatic awareness is described as having potential to enhance understanding and conscious use of inner healing mechanisms at the basis of the placebo effect.
本文概述了一个用于理解和治疗患有医学上无法解释症状的患者的体验式身心框架。该模型依赖于躯体觉知,这是意识的一个正常组成部分,以解决传统多学科方法中固有的身心二元论。躯体觉知代表一种指导性的治疗启发法,它允许对生物心理社会模型进行线性治疗应用。这种启发法承认患者身体症状的有效性,并确定愈合过程所需的心理和社会因素。躯体觉知用于指导应对方式、疾病信念、药物依赖和个人动态方面的改变,这些改变对于实现症状控制是必要的。身心概念与神经生物学模型一致并得到其支持,这些模型利用中枢神经系统机制来解释医学上无法解释的症状。这一概念也得到了最近一个关于外周结缔组织在影响疾病和健康方面可能发挥的作用的假设的支持。最后,躯体觉知被描述为有可能增强对基于安慰剂效应的内在愈合机制的理解和有意识的运用。