Source : International Herald TribuneWhen the woman, having experienced her fourth miscarriage, visited her physician, he gave her a surprising diagnosis: psychosomatic abortion. That is, she had lost the fetuses because of stresses in her life, particularly concerns about her religious affiliation and her husband's unwillingness to help out at home.
The doctor's recommended treatment? A series of vitamins, abstaining from sexual intercourse in future pregnancies and, most notably, psychotherapy, intended to explore childhood conflicts and other anxieties. The patient, according to her physician, Dr. Carl Javert, an obstetrician at Cornell University Medical College, subsequently had three successful pregnancies.
The diagnosis and the treatment fit the era in which they occurred. It was the early 1950s, and the field of psychosomatic medicine - based on the notion that many diseases have their origins in emotional distress - was in its heyday.
Was Javert onto something or was he misguided? Do his psychosomatic theories retain any currency today?
Throughout history, many doctors and patients have posited that emotions influence health. But it was not until the middle of the 20th century that efforts to prove an association accelerated. A driving force behind psychosomatic medicine was Dr. Franz Alexander, a Hungarian-born psychiatrist trained in the teachings of Freud.
Alexander, who taught at the University of Chicago, drew connections between personality types and diseases like hypertension, stomach ulcers and asthma. Chronic emotional disturbances, he believed, led to tissue changes in organs and thus a series of diseases.
Followers of Alexander devised quite evocative phrases to describe the emotional attitudes of people with certain diseases. The typical hypertensive patient, for example, felt "threatened with harm and has to be ready for anything," they said.
A second group of psychosomatic medicine advocates, the psychobiologists, focused on specific emotional events in people's lives, like the deaths of loved ones or the loss of employment, arguing that these traumas led to biological changes.
By the 1950s, the emotional issue most closely associated with disease was stress. Javert believed that an increasingly stressful world was contributing to miscarriages, usually called spontaneous abortions, among his patients. And he made it his mission to fight miscarriages, which he called "the country's foremost health problem."
Of particular concern to Javert were women who had "habitual abortions" - three or more miscarriages. The chief conflict experienced by such patients, he believed, was "fear of pregnancy and of the baby." These fears, in turn, led to "abortion neurosis," vividly depicted in Javert's 1957 book, "Spontaneous and Habitual Abortion," as a black octopus enveloping a woman.
To explain this, Javert turned to psychobiological theory, arguing that stress caused increased secretion of adrenaline. That hormone, in turn, produced premature uterine contractions that then caused spontaneous abortions.
Central to Javert's theories was a holistic view of medicine of the sort that today's medical schools try to teach. "The sciences of somatology and psychology," he wrote, "are employed in treating the patient as a complete individual."
Women who successfully gave birth after undergoing psychotherapy were fiercely loyal to him. But Javert's paternalism, typical of the predominantly male medical profession of the 1950s, would not go over so well today. The "doctor-priest," he wrote, should capitalize on the dependency of his patients when providing advice.
Kathleen Dixon, a philosopher at Bowling Green State University who has studied Javert's career, argues that his focus on women's fears and anxieties unfairly blamed them.
Also, Dixon says, Javert's data were suspect. His retrospective assessments of stress levels are probably inaccurate, and he never tested his regimen of vitamins and psychotherapy in any sort of unbiased, controlled clinical trial.
Subsequent research has failed to confirm the findings of Javert, who died in 1981.
But even though psychosomatics no longer has the cachet it once did, research into the mind-body interaction in medicine continues, seeking to prove a quotation attributed to Hippocrates: "It is more important to know what sort of person has a disease than to know what sort of disease a person has."
Barron H. Lerner teaches medicine and public health at Columbia University.
When the woman, having experienced her fourth miscarriage, visited her physician, he gave her a surprising diagnosis: psychosomatic abortion. That is, she had lost the fetuses because of stresses in her life, particularly concerns about her religious affiliation and her husband's unwillingness to help out at home.
The doctor's recommended treatment? A series of vitamins, abstaining from sexual intercourse in future pregnancies and, most notably, psychotherapy, intended to explore childhood conflicts and other anxieties. The patient, according to her physician, Dr. Carl Javert, an obstetrician at Cornell University Medical College, subsequently had three successful pregnancies.
The diagnosis and the treatment fit the era in which they occurred. It was the early 1950s, and the field of psychosomatic medicine - based on the notion that many diseases have their origins in emotional distress - was in its heyday.
Was Javert onto something or was he misguided? Do his psychosomatic theories retain any currency today?
Throughout history, many doctors and patients have posited that emotions influence health. But it was not until the middle of the 20th century that efforts to prove an association accelerated. A driving force behind psychosomatic medicine was Dr. Franz Alexander, a Hungarian-born psychiatrist trained in the teachings of Freud.
Alexander, who taught at the University of Chicago, drew connections between personality types and diseases like hypertension, stomach ulcers and asthma. Chronic emotional disturbances, he believed, led to tissue changes in organs and thus a series of diseases.
Followers of Alexander devised quite evocative phrases to describe the emotional attitudes of people with certain diseases. The typical hypertensive patient, for example, felt "threatened with harm and has to be ready for anything," they said.
A second group of psychosomatic medicine advocates, the psychobiologists, focused on specific emotional events in people's lives, like the deaths of loved ones or the loss of employment, arguing that these traumas led to biological changes.
By the 1950s, the emotional issue most closely associated with disease was stress. Javert believed that an increasingly stressful world was contributing to miscarriages, usually called spontaneous abortions, among his patients. And he made it his mission to fight miscarriages, which he called "the country's foremost health problem."
Of particular concern to Javert were women who had "habitual abortions" - three or more miscarriages. The chief conflict experienced by such patients, he believed, was "fear of pregnancy and of the baby." These fears, in turn, led to "abortion neurosis," vividly depicted in Javert's 1957 book, "Spontaneous and Habitual Abortion," as a black octopus enveloping a woman.
To explain this, Javert turned to psychobiological theory, arguing that stress caused increased secretion of adrenaline. That hormone, in turn, produced premature uterine contractions that then caused spontaneous abortions.
Central to Javert's theories was a holistic view of medicine of the sort that today's medical schools try to teach. "The sciences of somatology and psychology," he wrote, "are employed in treating the patient as a complete individual."
Women who successfully gave birth after undergoing psychotherapy were fiercely loyal to him. But Javert's paternalism, typical of the predominantly male medical profession of the 1950s, would not go over so well today. The "doctor-priest," he wrote, should capitalize on the dependency of his patients when providing advice.
Kathleen Dixon, a philosopher at Bowling Green State University who has studied Javert's career, argues that his focus on women's fears and anxieties unfairly blamed them.
Also, Dixon says, Javert's data were suspect. His retrospective assessments of stress levels are probably inaccurate, and he never tested his regimen of vitamins and psychotherapy in any sort of unbiased, controlled clinical trial.
Subsequent research has failed to confirm the findings of Javert, who died in 1981.
But even though psychosomatics no longer has the cachet it once did, research into the mind-body interaction in medicine continues, seeking to prove a quotation attributed to Hippocrates: "It is more important to know what sort of person has a disease than to know what sort of disease a person has."
Barron H. Lerner teaches medicine and public health at Columbia University.
When the woman, having experienced her fourth miscarriage, visited her physician, he gave her a surprising diagnosis: psychosomatic abortion. That is, she had lost the fetuses because of stresses in her life, particularly concerns about her religious affiliation and her husband's unwillingness to help out at home.
The doctor's recommended treatment? A series of vitamins, abstaining from sexual intercourse in future pregnancies and, most notably, psychotherapy, intended to explore childhood conflicts and other anxieties. The patient, according to her physician, Dr. Carl Javert, an obstetrician at Cornell University Medical College, subsequently had three successful pregnancies.
The diagnosis and the treatment fit the era in which they occurred. It was the early 1950s, and the field of psychosomatic medicine - based on the notion that many diseases have their origins in emotional distress - was in its heyday.
Was Javert onto something or was he misguided? Do his psychosomatic theories retain any currency today?
Throughout history, many doctors and patients have posited that emotions influence health. But it was not until the middle of the 20th century that efforts to prove an association accelerated. A driving force behind psychosomatic medicine was Dr. Franz Alexander, a Hungarian-born psychiatrist trained in the teachings of Freud.
Alexander, who taught at the University of Chicago, drew connections between personality types and diseases like hypertension, stomach ulcers and asthma. Chronic emotional disturbances, he believed, led to tissue changes in organs and thus a series of diseases.
Followers of Alexander devised quite evocative phrases to describe the emotional attitudes of people with certain diseases. The typical hypertensive patient, for example, felt "threatened with harm and has to be ready for anything," they said.
A second group of psychosomatic medicine advocates, the psychobiologists, focused on specific emotional events in people's lives, like the deaths of loved ones or the loss of employment, arguing that these traumas led to biological changes.
By the 1950s, the emotional issue most closely associated with disease was stress. Javert believed that an increasingly stressful world was contributing to miscarriages, usually called spontaneous abortions, among his patients. And he made it his mission to fight miscarriages, which he called "the country's foremost health problem."
Of particular concern to Javert were women who had "habitual abortions" - three or more miscarriages. The chief conflict experienced by such patients, he believed, was "fear of pregnancy and of the baby." These fears, in turn, led to "abortion neurosis," vividly depicted in Javert's 1957 book, "Spontaneous and Habitual Abortion," as a black octopus enveloping a woman.
To explain this, Javert turned to psychobiological theory, arguing that stress caused increased secretion of adrenaline. That hormone, in turn, produced premature uterine contractions that then caused spontaneous abortions.
Central to Javert's theories was a holistic view of medicine of the sort that today's medical schools try to teach. "The sciences of somatology and psychology," he wrote, "are employed in treating the patient as a complete individual."
Women who successfully gave birth after undergoing psychotherapy were fiercely loyal to him. But Javert's paternalism, typical of the predominantly male medical profession of the 1950s, would not go over so well today. The "doctor-priest," he wrote, should capitalize on the dependency of his patients when providing advice.
Kathleen Dixon, a philosopher at Bowling Green State University who has studied Javert's career, argues that his focus on women's fears and anxieties unfairly blamed them.
Also, Dixon says, Javert's data were suspect. His retrospective assessments of stress levels are probably inaccurate, and he never tested his regimen of vitamins and psychotherapy in any sort of unbiased, controlled clinical trial.
Subsequent research has failed to confirm the findings of Javert, who died in 1981.
But even though psychosomatics no longer has the cachet it once did, research into the mind-body interaction in medicine continues, seeking to prove a quotation attributed to Hippocrates: "It is more important to know what sort of person has a disease than to know what sort of disease a person has."
Barron H. Lerner teaches medicine and public health at Columbia University.
Shokin
It's freakishly long. :(
