Helman C G
Cult Med Psychiatry. 1985 Mar;9(1):1-26. doi: 10.1007/BF00048535.
This pilot-study examines the self-perceptions, and explanatory models, of 42 patients with either respiratory or gastrointestinal psychosomatic disorders. For several reasons, these disorders comprise an anomalous category within the biomedical model. It is suggested that clinicians explain their chronic, unpredictable course by 'psychologization'--shifting responsibility for etiology, exacerbations or therapeutic failure to patients' emotions, personality, or lifestyle. Evidence is presented that psychologization is socially constructed, in clinical encounters over time. Patients respond to this process by reifying pathogenic emotions, personality traits, or malfunctioning body parts, and thus separating them from an idealized concept of the social self. It is also suggested that patients with gastrointestinal or respiratory conditions differ in their self-perceptions and explanatory models: a proportion of patients in each group organize their experiences around a central natural symbol--respiration or digestion/excretion. These 2 images link physiological experiences to concepts of pathogenic emotions or personality, physical weakness, and types of social relationships.
这项试点研究考察了42名患有呼吸或胃肠身心障碍患者的自我认知及解释模型。由于多种原因，这些障碍在生物医学模型中属于异常类别。有人认为，临床医生通过“心理化”来解释这些疾病慢性且不可预测的病程，即将病因、病情加重或治疗失败的责任归咎于患者的情绪、性格或生活方式。有证据表明，随着时间推移，在临床诊疗过程中，心理化是社会建构的。患者通过将致病情绪、性格特质或身体机能失常的部位具体化来回应这一过程，从而将它们与理想化的社会自我概念区分开来。研究还表明，患有胃肠或呼吸疾病的患者在自我认知和解释模型方面存在差异：每组中有一部分患者围绕一个核心自然符号——呼吸或消化/排泄来组织他们的经历。这两个意象将生理体验与致病情绪或性格、身体虚弱以及社会关系类型的概念联系起来。
