Psychological factors in healing: a new perspective on an old debate.
Psychological factors in healing: a new perspective on an old debate.
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治疗中的心理因素：老争论的新视角。
DOI：
10.1080/08964289.1992.10544235
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Benson,H
中科院分区：
文献类型：
--
作者：
Myers,SS;Benson,H
在过去的 20 年里，来自行为医学、神经免疫学、神经内分泌学、社会医学和精神病学等不同学科的医学研究人员聚集在一起，努力加深对心理因素对身体健康影响的理解和接受。医学界的许多人仍然有些怀疑，声称治疗的心理成分很大程度上是“民间传说”，没有确凿的证据证实！心理因素的支持者反过来批评这种怀疑论是毫无根据的和教条主义的。 2• 3 我们的目标是超越这场辩论，试图澄清这一僵局的意识形态和历史根源。这种澄清是必要的，因为争论的基础是一个更广泛和更基本的问题，即什么是可接受的医学模式，更具体地说，我们可以通过什么标准来判断“确凿”的证据。如果不关注这些更大的问题，就心理因素与主流医学实践的相关性达成共识就不会取得什么进展。关于心身领域研究有效性的争论往往无法达成任何共识。我们定义“有效性”的方式取决于我们的健康和医学模式，并随之变化。我们目前的模型是这样构建的，即心理和社会因素等非物质的、不可还原的、非普遍的元素，根据定义，是“软的”，因此是无效的。将心理因素更充分地纳入医学的支持者和反对者陷入了僵局，这主要不是因为他们对该领域研究的分析存在分歧，而是因为他们采用不同的医学模式。
Over the last 20 years, medical researchers from a variety of disciplines, including behavioral medicine, neuroimmunology, neuroendocrinology, social medicine, and psychiatry, have converged in an effort to produce greater understanding and acceptance of the effects of psychological factors on physical health. Many in the medical profession have remained somewhat skeptical, claiming that psychological components of healing are largely" folklore," unsubstantiated by hard evidence! The proponents of psychological factors have, in tum, criticized this skepticism as being unwarranted and dogmatic. 2• 3 Our goal is to go beyond this debate in an attempt to clarify the ideological and historical roots of this impasse. Such clarification is essential because underlying the debate is a broader and more fundamental question about what is an acceptable medical model and, more specifically, by what criteria we may judge" hard" evidence. Without bringing these larger issues into focus, little progress will be made in reaching consensus on the relevance of psychological factors to mainstream medical practice.Debates about the validity of research in the mindbody field often fail to produce any consensus. The way we defme" validity" depends on, and changes with, our models of health and medicine. Our current model is constructed so that such nonmaterial, nonreducible, nonuniversal elements as psychological and social factors are, by defmition," soft" and, therefore, invalid. Proponents and opponents of incorporating psychological factors more fully into medicine reach an impasse, not primarily because they disagree on their analysis of research in the field, but because they are operating from different medical models.