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Psychosomatic medicine (PM) is predicated on the axiom that there are no diseases per se but only sick people. In this view, disease is not an abstract entity that can be studied in its own right apart from the person. PM is not a subspecialty of medicine dedicated to the study of one bodily organ or system and its constituent cells; its boundaries are not defined by a special technology whereby these may be studied. Rather, it comprises an integrative approach to medicine, which maintains that the cultural, human, social and physical environment in which persons live plays a role in the etiology, pathogenesis and maintenance of disease. By virtue of the impact of environmental events on the minds of people — programmed as they are by genetic endowment, life experiences, education, and endowed with intelligence and personal conflicts — some are more, and others, less able to resist, overcome or cope with their experiences.
This may be an idiosyncratic statement of the current understanding of PM, but it contains the reasons why the term has largely been abandoned, in the face of the evidence that (1) no single factor accounts for the etiology and pathogenesis of any disease, regardless of whether that factor be genetic, infectious, nutritional, behavioral, psychological or social; (2) diseases are all multifactorial in nature; (3) diseases are heterogeneous in nature; (4) social and psychological factors play a variable role in maintaining