A Piece of My Mind Section Editor: Roxanne
K. Young, Associate Editor.
Recently I've been having a discussion with Susan, a patient who has
bipolar disorder. She tells me she is afraid her illness is her fault. She
believes that if she were a stronger person, she would be able to overcome
this illness, that if she were a better person, she would perhaps never have
gotten it in the first place. This morning she told me she sometimes worries
that God is punishing her with this illness.
Susan is certainly not the first person I've encountered with such beliefs.
I practice family medicine. Perhaps because my first job after residency was
in a clinic that served Salvadoran refugees—war survivors—and
because I saw how frequently the stress of trauma and homesickness took a
toll on their bodies, I have long been interested in connections between mind
and body. And I have benefited from the legacy of those who have elaborated
on these connections. The Hippocratic writings include many references to
interrelationships between soma and psyche.1 Hans
Selye2 began to elucidate for us the mechanisms
of stress and illness. Herbert Benson3 began
the study of the relaxation response. I think most persons would agree now
that stress tends to contribute to illness and can play a role in both its
onset and its aggravation. Reducing stress tends to make people feel better.
Morrow DS. Not Guilty. JAMA. 2002;288(24):3084-3085. doi:10.1001/jama.288.24.3084