Doctors have long known that the responses of the intestines, stomach, skin, and blood pressure are often more reliable than the answers of the patients themselves.

Two years ago, the Department of Dermatology at National Taiwan University Hospital (NTUH) established a clinic for psychosomatic skin problems, because a number of patients only developed chronic numbness, itches, and other problems as a result of psychological or emotional pressure. It is necessary to draw on the knowledge and experience of psychological care to effectively treat the patients.

So-called psychosomatic illness simply means that psychological or emotional problems affect one's body, and are revealed in illness.

What is going on in your body is this: when the brain surface feels stimulation or disappointment, it notifies system along the edge of the brain and hypothalamus ensconced in the lower part of the right brain. It is only about as large as a small plum, but controls the whole nervous system and the pituitary gland. Consequently, it affects the control of the glandular secretion system, which controls the autonomous nervous systems of all the organs in the body. Given their interaction with the central nervous system, this influences the immune functions of the body.

Sometimes a psychological illness does not only reveal itself in a single health problem, but in the development of many. So when some people's stomachs feel better, their head aches, and when their head is OK, it switches to the chest. As for why each individual's psychosomatic illness situation is different, there is still no definitive answer, but most doctors ascribe it to weak points in the patient's physical condition.

Because of this, most doctors believe that "virtually every department in the hospital needs to add a psychosomatic illness clinic."

Although psychosomatic illnesses caused by pressure are not unique to industrial society, people may come under pressure at any time following the accelerating pace of life, intensification of work competition, and the information explosion. Add to this the population density and traffic chaos brought about by urbanization, the lack of recreational facilities, and noise and air pollution, and "looking at the overall environment, life is really much harder for modern people than for those in the past," concludes Wang Shou- cheng, director of the Department of Family Medicine at the Taipei City Psychiatric Center.

Chang Den-chyi, directing physician in the Department of Psychology at Cathay Hospital, points out that according to statistics, one out of every five people in advanced industrial countries has some kind of neurosis disorder to some degree.

Comparing three studies done two years ago by the Psychiatric Center, the conclusions are that: In the last ten years, emotional disorders and psychosomatic illnesses resulting from pressure and changes in the external environment have increased by more than ten percent.

Comparatively, the more obvious the physical symptoms of a psychosomatic illness, the less the patient feels psychological pressure. But this does not mean that the psychological pressure that they face is really less.

Chang Den-chyi points out that Chinese are especially prone to hiding their emotions and do not express their feelings so outwardly like Westerners do. When they are happy, they fear that "sadness follows when happiness reaches too great an extreme," and when sad, they just say "nothing's wrong" to anyone who asks. Many Chinese cannot release their emotions, so that most emotional pressures are expressed through the body, and they feel chest pain, rapid heartbeats, headaches and so on. "Chinese are a relatively strongly 'physiologized' nationality" stresses Chang.

A study was done of women in the US, India and China about the responses to having their ovarian tubes tied. The study discovered that relatively more American women displayed anxiety emotionally, that more Indian women showed symptoms of hysteria, and that Chinese women were more likely to feel that they had a backache, their stomachs hurt, they were unable to sleep, or they felt weak and exhausted.

There are countless examples. Chang Den-chyi talks about those who don't get along with their wives or parents, or are unsatisfied with the boss, but don't dare to protest or fight back. As a result, they get all kinds of "sicknesses." Often when people face pressure, adrenaline and glandular secretions rise sharply, and they are able to do things that they ordinarily could not do. But usually when the pressure disappears, they suffer a debilitating illness. Thus, functionally speaking, psychosomatic illnesses may permit the release of emotions and serve a "safety valve" function.

For most people, if there is only isolated pressure which is neither extreme nor sustained leading to headaches, heart palpitations, stomach disorders or soreness in the muscles, it's not a serious problem. But if physically one has some inherited weaknesses, past illnesses or a relatively weak capacity to endure pressure, then it is very possible that an illness would be brought on or worsened when he or she is faced with relatively greater pressure or emotional change.

However, it is no easy feat to precisely determine the relationship between mind and body. As far as doctors are concerned, "what's important is that psychological factors not be ignored when someone is sick," says Chang Tien-chi. This is not only a principle for doctors to follow, but some common wisdom everyone should know when they fall ill.

[Picture Caption]

Today people's hearts and minds are subject to a host of pressures, which is why psychosomatic illnesses are on the rise. (photo by Pu Hua-chih.)