The Time Has Come For “Ergasiology” To Replace “Psychosomatic Medicine?”

Dr. Jim Amos with Dr. Don Lipsitt's book Foundations of CL Psychiatry - CopyAs you know, I’ve been reading Dr. Don Lipsitt’s new book, “Foundations of Consultation-Liaison Psychiatry: The Bumpy Road to Specialization.” It’s fascinating reading and I highly recommend it to anyone who wants to know what drives Consultation-Liaison Psychiatrists to do what we do.

I found an interesting word in the section Psyche and Soma: Struggles to Close the Gap–“ergasiology.” It’s especially pertinent to the name change crisis now occurring amongst leaders of the Academy of Psychosomatic Medicine (APM). Recall they sent the membership a poll in late April which asked whether or not the name “Psychosomatic Medicine” should be changed. It’s probably worth recapping the concerns:

 

  1. It does not clearly or accurately define the clinical practice in the field
  2. The name can be confusing and ambiguous, which complicate our efforts toward collaborative care
  3. The term “psychosomatic” is commonly perceived as pejorative because it is generally considered to refer to illnesses with no physiological basis or to patients who are feigning symptoms

 

The APM Council presumably has the poll results by now. I have yet to hear anything although they might be holding off until the annual meeting in Austin, Texas in November. I’m afraid I’ll be unable to attend because I’ll be on duty on the consult service.

The American Psychosomatic Society (APS) has already been through this struggle and elected not to change the name of its organization.

A practical book you can use

A practical book you can use

Dr. Jeanne Lackamp, MD

Dr. Jeanne Lackamp, MD

The other thing I noticed about Dr. Lipsitt’s book is that he mentions the chapter on consultation technique written by a fomer trainee of mine, Dr. Jeanne Lackamp, in a book edited by me and Dr. Robert G. Robinson:

“Another helpful account of the consultation technique is the chapter by Lackamp in Psychosomatic Medicine and Consultation-Liaison Psychiatry (Amos & Robinson, 2010).

Anyway, now that I’ve plugged my book and praised Dr. Lackamp, returning to “ergasiology,” the term is in the Notes section of the section named above in Dr. Lipsitt’s book:

“Nemiah(Taylor 1987) notes a (1796) poetic mention of the word psychosomatic in Coleridge’s early works. It is believed that Dunbar (1948) was first to use the term in American Literature. The term itself, first thought to supplant the word functional, created some dissension because it appeared to preserve the very dichotomy it was intended to mend. But it was ultimately accepted as more palatable to physicians than Meyer’s suggested alternative ergasiology (the science of energy economy) (Lief, 1948, pp. 544-5.”

This gives you a sense of the erudition of Dr. Lipsitt, whose prose will not allow the casual reader to simply scan it for keywords, as one can do in most on-line texts ( and which could be making us stupid), such as what you find in Wikipedia, an example of which follows in the excerpt on Adolf Meyer, the famous psychiatrist who was the first psychiatrist-in-chief of Johns Hopkins Hospital and who is know mainly for his contribution of the idea of psychobiology:

“Meyer’s main theoretical contribution was his idea of ergasiology (a term he derived from the Greek for “working” and “doing”) to describe a psychobiology. This brought together all the biological, social and psychological factors and symptoms pertaining to a patient. It considered mental illnesses to be a product of dysfunctional personality not a pathology of the brain. Believing that whole-life social and biological factors should be central to both diagnosis and treatment Meyer was one of the earliest psychologists to support occupational therapy as an important connection between the activities of an individual and their mental health, and incorporated community based activities and services to develop people’s everyday living skills.”–Wikipedia entry on Adolph Meyer.

There you have it–the answer to our problem with the word “Psychosomatic Medicine” is to simply adopt the name “Ergasiology,” become dedicated ergasiologists developing the study of ergasiometrics, take our patients’ blood pressures with the recently developed ergasiomanometry instruments now available at Wal-Mart and we’re in business. While some might object on the grounds it sounds sort of like a gastrointestinal disease, they can just take Pepto-Bismol.

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