ACADEMIA Letters

Psychosomatic as we know
Luma Melo, University of Pittsburgh

Along human existence, many theorists believed there was an emotional predisposition to
causes of disease; however, no specific term for such belief was pinpointed until the early 19th
century. Although some authors [1] believe that is impossible to determine when and where
the psychosomatic term originated, the first documented use of the term “psychosomatic” ap-
peared in publications in 1838 in the journal Zeitschrift fur die Beurtheilung und Heilung der
krankhaften Seelenzustiinde2 ‘Journal for the judgment and cure of the pathological mental
illness’.
Psyche, soma, psychic and somatic were used independently long before being combined
into inseparable aspects of the individual organism. The combined terms psycho-physical,
psychical medicine, and mental medicine were used before the introduction of the term psy-
chosomatic, as were psychic and psychotherapy.[2] However, only in the nineteenth-century
that scholars focused on psychiatric disorders and psychological disturbances experienced a
paradigm change. Some started to consider emotions in health sciences in both mental and/or
physical disorders. This shift in the conception of the body came under intense scrutiny as
part of the laboratory revolution of the British medical culture at that time.
During this period the perspective was that the body impacted mental phenomena, and
many of the supporters of this theory had rigid opinions that resulted in confusing religion
and philosophy with medicine and common sense.[2] In this scenario that the psychiatry pro-
fessor Johan Cristian Heinroth (1773-1843) arose with his theory that the mind and body as
connected and complementary and one could not distinguish one from another and the body
and soul interacted in several ways. Although they were thought of as a unit, he believed that
the soul had primacy over the body.
Besides teaching psychiatry at Leipzig, Heinroth was the leader of the so-called “Spiritu-
alistic” or “Psychic” school of psychiatry in Germany at the time[3],[4] and is best known as

Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0

Corresponding Author: Luma Melo, lum53@pitt.edu

Citation: Melo, L. (2021). Psychosomatic as we know. Academia Letters, Article 3145.
https://doi.org/10.20935/AL3145.

1
the first chair holder of psychiatry in Europe, perhaps even the first in the world.[5] Heinroth
was one of the most prominent and radical figures of the early nineteenth-century psychia-
trists who believed in a mental (soul caused) approach to psychiatry, in contrast to those who
followed the somatic approach.[5]
Heinroth believed that the doctor’s responsibility was to cure their patients. For him,
all patients could be cured within Christian moral laws.[5] Thus, he reinforced the idea that
mentally ill people could recover and be cured, but only if she or he renounced all earthly
passions and bodily needs and restricted herself or himself.[8]
Not only Heinroth was the one responsible for pinpointing the term psychosomatic, but
he also defined depression with a psychopathological meaning for the first time, and not as a
physiological condition of brain pressure.[8]
Heinroth dedicated himself entirely to the psychosomatic matter and was responsible for
great advances in psychiatry[1,2,6]. However, according to Steinberg[5], Heinroth was not an
active member of the church, he was a deeply religious man. Thus, because of his mystical and
Christian ideas, some of his religious explanations of mental mechanisms and insanity were
bitterly attacked7, and he might not have received enough credit for his work. An example
of this is that one normally links psychosomatic with Freud, but it is inaccurate to claim that
Freud was the first to use the term. [13],[5]
Although Heinroth was the first to use the term, was only in the 20th century that Hans
Selye (1907-1982) introduced it to medicine. A new meaning for the term psychosomatic
emerged, and it was the first time the term was used as the causation of psychological processes
in the nervous and immune systems in humans, i.e., having stress, for example, as the cause
of disease.
Selye was born in Slovakia (at the time Hungary) but migrated to North America to work
as a research fellow. He put animals under different physical and mental adverse conditions
and noted that under these difficult conditions the body consistently adapted to heal and re-
cover. In 1936 Selye discovered and described the General Adaptation Syndrome (GAS), later
renamed by Selye “stress response”.[6] In that year Hans Selye’s single-author short letter to
Nature [15] inspired a vast and still growing wave in medical research. Nonetheless, Selye
was internationally recognized as a world authority in endocrinology, steroid chemistry, ex-
perimental surgery, and pathology. [15]
He first observed the symptoms of GAS after injecting ovarian extracts into laboratory rats:
an experiment he performed with the intent of discovering a new hormone. Instead, he found
that the extract stimulated the outer tissue of the adrenal glands of the rats, caused deterioration
of the thymus gland, produced ulcers, and finally death. He eventually determined that these
effects could be produced by administering virtually any toxic substance, physical injury, or

Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0

Corresponding Author: Luma Melo, lum53@pitt.edu

Citation: Melo, L. (2021). Psychosomatic as we know. Academia Letters, Article 3145.
https://doi.org/10.20935/AL3145.

2
environmental stress. [7]
His experiments on rats showed that if the organism is severely damaged by acute nonspe-
cific nocuous agents–such as exposure to cold, surgical injury, production of spinal shock, ex-
cessive muscular exercise, or intoxications with sublethal doses of diverse drugs as adrenaline
or morphine–a local syndrome is induced. The symptoms of which are independent of the
nature of the damaging agent or the pharmacological type of the drug employed, and represent
rather a response to damage as such.[18]
Selye was able to extend his theory to humans, demonstrating that a stress-induced break-
down of the hormonal system could lead to conditions, such as heart disease and high blood
pressure. He called these “diseases of adaptation.”[8]
Along with other researchers like Helen Flanders Dunbar (1902-1959) and Franz Alexan-
der (1891 - 1964), Selye reinvented the term psychosomatic. Alexander and Dunbar had dif-
ferent approaches about what a psychosomatic disease meant; however, as an endocrinology
expert, Selye was only interested in what stress itself could cause biologically to our body.
Considering this, one can say that he was responsible for reinventing the meaning of psycho-
somatic as most people use it today.[9]
Another term coined by Selye was stress, and finding an acceptable definition of it was a
problem that haunted Selye his entire life. [10],[11] Although Selye’s contributions to modern
understandings of stress were incomparable, retrospective evaluation of Selye’s experimental
model was questioned due to the deemed obsolete and unethical approaches used. He would
often stress the animals by starvation, extreme temperatures, and excessive exercise. In 1970
John Todd, an English physician, dismissed the General Adaptation Syndrome (GAS) as one
of “the errors of medicine.”[12] At the same time, for other scholars like Claude Fortier, Selye
was “one of the rare giants of contemporary biology,” blessed with intuition, intellectual depth,
and remarkable energy.[16]
Nowadays psychosomatic is believed to be a new specialty of medicine - so entitled psy-
chosomatic medicine[13]- an interdisciplinary medical field exploring the relationships among
social and psychological factors on bodily processes. Nevertheless, there is nothing novel
about this field. Margetts1 even writes “let us hope that over the years it will be used less fre-
quently or at least used more accurately and that it will not point out another “sub-specialty”
of medicine”. [14] The impression that it is new is caused by the influx of publication in the
last years. The number of publications with psychosomatic in the title is thirteen times greater
in the last 17 years than compared to the early 19th century.* On top of that, terms such as
stress also rose at the same time and, nowadays, such term has become such an ingrained part
of our vocabulary and daily existence, that it is difficult to believe that our current use of the
term originated just a little more than 50 years ago.

Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0

Corresponding Author: Luma Melo, lum53@pitt.edu

Citation: Melo, L. (2021). Psychosomatic as we know. Academia Letters, Article 3145.
https://doi.org/10.20935/AL3145.

3
References
1. WALLACE, E. R. . G. J. History of Psychiatry and Medical Psychology. Boston:
Springer, 2008.

2. MARGETTS, E. The Early History of the Word Psychosomatic. Canadian Medical

Association Journal , p. vol 63, 1950.

3. STEINBERG, H. Beginn der akademischen Psychiatrie des Abendlandes. Die Errich-

tung der ersten Professur für Heinroth in Leipzig vor 200 Jahren.. Nervenheilkunde,
2011. 30:997-1001. 16.

4. STEINBERG, H. . H. H. Johann Christian August Heinroth (1773–1843): The First

Professor of Psychiatry as a Psychotherapist. Journal of Religion and Health, June
2012. 256–268.

5. NERVENARZT, S. H.. Die Errichtung des ersten psychiatrischen Lehrstuhls: Johann

Christian August Heinroth in Leipzig. Der Nervenarzt, march 2004. 75:303-7. 13.

6. SZABO, S., TACHE, Y., SOMOGYI, A. The legacy of Hans Selye and the origins of
stress research: a retrospective 75 years after his landmark brief “letter” to the editor of
nature. Stress, 15 (2012), pp. 472-478

7. SELYE, H. The physiology and pathology of exposure to stress. Oxford: Acta, 1950.

8. SELYE, H. Stress, and disease. Science, 7 Oct 1955. 122: 625-631.

9. DUNBAR H. F., Emotions And Bodily Changes. American Journal of Psychiatry,

1935, 93(3), p. 749.

10. ROSCH, P. Reminiscences of Hans Selye, and the Birth of “Stress. The American In-
stitute of Stress, 3 Nov 2017. Available at: <https://www.stress.org/about/hans-selye-
birth-of-stress/>.

11. NEYLAN, T. Hans Selye and the Field of Stress Research. Neuropsychiatry Clin
Neurosc, 1998. 10: 230.

12. JACKSON M. Evaluating the Role of Hans Selye in the Modern History of Stress.
In: Cantor D, Ramsden E, editors. Stress, Shock, and Adaptation in the Twentieth Cen-
tury. Rochester (NY): University of Rochester Press; 2014 Feb. Chapter 1. Available
from: https://www.ncbi.nlm.nih.gov/books/NBK349158/

Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0

Corresponding Author: Luma Melo, lum53@pitt.edu

Citation: Melo, L. (2021). Psychosomatic as we know. Academia Letters, Article 3145.
https://doi.org/10.20935/AL3145.

4
 13. U.S. National Library of Medicine. Available from < https://www.nlm.nih.gov/exhibition/
emotions/psychosomatic.html > Accessed on December 11th. * Search on Google
Scholar on August 17th, 2021.

14. WALLACE, E. R. . G. J. History of Psychiatry and Medical Psychology. Boston:

Springer, 2008.

15. SZABO, S., TACHE, Y., SOMOGYI, A. The legacy of Hans Selye and the origins of
stress research: a retrospective 75 years after his landmark brief “letter” to the editor of
nature. Stress, 15 (2012), pp. 472-478

16. JACKSON M. Evaluating the Role of Hans Selye in the Modern History of Stress.
In: Cantor D, Ramsden E, editors. Stress, Shock, and Adaptation in the Twentieth Cen-
tury. Rochester (NY): University of Rochester Press; 2014 Feb. Chapter 1. Available
from: https://www.ncbi.nlm.nih.gov/books/NBK349158/

Academia Letters, August 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0

Corresponding Author: Luma Melo, lum53@pitt.edu

Citation: Melo, L. (2021). Psychosomatic as we know. Academia Letters, Article 3145.
https://doi.org/10.20935/AL3145.