The Implications of a Theory of Mind-Body Unity for Doctor-Patient Relations in Medicine

As the science of neurobiology progresses and our knowledge of the nervous system and its functions becomes more complete, it grows increasingly less justifiable to segregate a patient’s mind and body as two separate entities. Continually medical journals are publishing are a growing number of articles documenting a correlation between patients’ psychiatric, emotional wellness and the health of their physical persons. With such amassing evidence, it seems necessary for there to be a change in the way medicine is practiced. As science comes to more fully grasp the role that a person’s psyche plays in the healing process, medical professionals must adjust the way they practice medicine, as patients must adjust their conception of their role in the healing process, to take full advantage of the more complete understanding of the relationship between the mind and body.

Traditionally, society has considered mind and body to be medically separate. However, this assumption has become less and less tenable as more and more scientific evidence points to the contrary. One study, examining the therapeutic effects of journaling on asthma and rheumatoid arthritis patients, concludes:

“patients with mild to moderately sever asthma or rheumatoid arthritis who wrote about stressful life experiences had clinically relevant changes in health status… compared with those in the control group. These gains were beyond those attributable to the standard of medical care that all participants were receiving.” [1]

A second study, in which students were given two identical minor wounds, the first during summer vacation and the second during a major exam period in the school semester, found that the second wound took an average of three days longer to heal than the first. This lead researchers to conclude that “even something as transient, predictable, and relatively benign as examination stress can have significant consequences for wound healing.” [2] These studies, along with many others like them, make necessary a call for a change in the way we as a culture conceptualize mind-body phenomena, and the way we practice medicine.

The popular dualistic perception of mind and body has been observed to result in the “tendency of some modern bio-medical practices to treat the sick person as if he or she were a passive object—if not a corpse…” [3] This view of a patient’s role in his or her recovery as an essentially passive one could not continue under a system of unification of mind and body. The current suggested modus operandi of a patient in recovery to sit back, and stay out of the way while the body heals itself could not be advised if the affect of a patient’s consciousness on his or her nervous system, and therefore his or her body, where considered an integral part of recovery. Rather than stepping back from the healing process, a patient would have to see him or herself as an active participant in recovery, with the ability, at least in part, to willfully aid or impair his or her own healing.

The necessary non-passivity of the patient under a system of non-duality carries over into far more that just the patient’s role in the recuperation process. It completely revolutionizes the modern conception of the doctor-patient relationship. In this new doctor-patient dynamic, the doctor must perform both as physician and psychiatrist, seeking a much deeper understanding of the patient as a whole person than is currently done in most medical practices. For his or her own part, the patient can no longer perceive the task of diagnosis and healing as the doctor’s job alone. One consequence of a unified mind and body is that without active participation on the part of the patient, complete healing cannot take place. Therefore, the doctor-patient relationship becomes much more a dynamic partnership in healing rather than that of a physician mending a body in the same way a cobbler might mend a shoe. In recognizing the power of intentionality in affecting the soma through the nervous system, doctor and patient alike take a responsibility to enter into this new kind of relationship.

Furthermore, institutions such as hospitals and hospice homes would be morally obligated to operate in such a way as to promote this new sort of doctor-patient relationship. There are currently some practices which conduct themselves in such a manner as to promote holistic care for their patients. However, this method of operation is not standard for most institutions, and such practices are usually available only to those who can afford to pay exorbitant prices for their health care. Conceptualizing the patient as a union between mind and body via the nervous system demands that hospitals and other health-care facilities reconfigure their administrative policies to reflect the necessity for a doctor to treat both psychological and well as somatic aspects of illness in order to effectively administer treatment.

However, it seems that it will only be once patients and health-care providers alike being to experience these changes in the cultural practice and perception of medicine that the idea of a unified mind and body will be taken seriously. Unfortunately, it is the very belief in a unified mind and body which will stimulate these changes in the health-care system. Thus, it seems that in order for current conventional Western medicine to embody the holistic medical practice advocated by a theory of mind-body unity, it needs the very changes which are only possible in the environment which they are needed to produce.

Despite this apparent catch-22, support for such a categorical shift has arisen among the health-care community, and by collectively speaking out for change, it is possible to create a local environment that is hospitable to holistic medicine. Already some medical professionals are calling for “a paradigm shift in which unexplained symptoms are remedicalized around the notion of a functional disturbance of the nervous system, and treatments currently considered ‘psychiatric’ are integrated into general medical care”[4]. Perhaps as support for a mind-body unity grows and more scientific evidence in favor of holistic medicine is popularized within main-stream culture, these local acceptances of a non-dual mind and body will spur the greater medical community to investigate the possibility of regularly practicing psychosomatic healing.

Therefore it can be concluded that in response to the ample medical and scientific evidence supporting a non-dualistic conception of mind and body, significant reconfiguring of both individual relationships between doctors and patients and the administrative policies of medical institutions will have to be implemented as we being to culturally internalize such a notion of mind-body unity. While it seems impossible for a pan-cultural revolution to take place, there is still the ability of grass-roots holistic medical practices to encourage society at large to adopt a unified conception of mind and body, and to accept each person as a biological unity of an individual and indivisible embodied spirit.

Works Cited:

1.

“Effects of Writing About Stressful Experiences on Symptom Reduction in Patients with Asthma or Rheumatoid Arthritis: A Randomized Trial”

By Joshua M. Smyth, PhD; Arthur A. Stone, PhD; Adam Hurewitz, MD; Alan Kaell, MD

Journal of American Medicine, April 14, 1999—Vol 281, No. 14, pp 1304-1308

Available as of May 15, 2008 on JAMA’s website: http://jama.ama-assn.org

2.

“Mucosal Wound Healing Is Impaired by Examination Stress”

By Phillip T. Marucha, DMD, PhD; Janice K. Keicolt-Glaser, PhD; Mehrdad Favagehi, DDS

Psychiatric Medicine—Vol 60, Issue 3, pp 362-365

Copyright 1998

Available as of May 15, 2008 on the web at http://www.psychosomaticmedicine.org/cgi/content/abstract/60/3/362

3.

“Mind-Body Dualism and the Biopsychosocial Model of Pain: What Did Descartes Really Say?”

By Grant Duncan

Journal of Medicine and Philosophy, August 1, 2008—Vol. 25, No. 4, pp 485-513

Abstract generally available and full text available for purchase as of May 15, 2008 on the web at http://www.ingentaconnect.com/content/routledg/jmep/2000/00000025/00000004/art00007

4.

“’Unexplained’ Somatic Symptoms, Functional Syndromes and Somatization: Do We Need A Paradigm Shift?”

By Michael Sharpe, MA, MRCP, MRCPsych; Alan Carson, MB, MRCPsych, MPhil

Annals of Internal Medicine, May 1, 2001—Vol. 134, Issue 9, Part 2, pp 926-930

Available as of May 15, 2008 on the web at http://annals.highwire.org/cgi/content/abstract/134/9_Part_2/926