Psychosomatic Medicine in Primary Care
The theoretical basis of Psychosomatic Medicine is the biopsychosocial model system. This system describes the interactions among the biological, psychological, and social processes that are involved, to different extents, in each disease. In many Western countries, basic knowledge about recognizing psychological and psychosomatic disorders and problems, counseling and providing emotional support, and providing referrals to health specialists are included in the training of medical students and postgraduate doctors. The objectives of the psychosomatic approach are to build bridges between the various clinical disciplines to overcome the mind–body dichotomy and to stress the importance of understanding the interactions among biology, psychology, and social factors in every patient, independent of the primary pathology that is being treated. These objectives imply both a system-based perspective and knowledge of the biological, psychological, and social subsystems and their interactions. The psychosomatic approach focuses on the doctor–patient relationship and on an integrative strategy for diagnosing and treating patients. Educating and training the somatic clinician to integrate psychosomatic aspects of medical care into his/her daily work has become a well-accepted priority for training and research.
Psychosomatic Medicine in primary care has primarily been influenced by psychoanalysts and internists who emulated Balint’s approach in 1964, which stressed the integration of psychosomatic and holistic perspectives in the medical practice model.