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by Peter Shoenberg, (Palgrave Macmillan, 2007, £19.95, 272pp plus xvi)
‘Psychosomatic medicine’ is a rather unfashionable term. Historically, it has been associated with hypnotism and with the idea that there is a circumscribed set of ‘psychosomatic’ disorders. In the hands of Dunbar, Alexander and French, these were syndromes that had physical signs and symptoms, posing a serious threat to health, which could be alleviated by psychoanalytic treatment, provided this was of sufficient depth. The steady displacement of ‘psychosomatic medicine’ by ‘health psychology’ has brought two kinds of problems. One is a tendency to restrict its clinical scope in a different way, as another professional coterie takes the place of those medical psychosomatists. The other has been an exclusive reliance on psychological and social research with clinical populations in understanding the development of illness and individuals' reactions to it, to the exclusion of insights based on developmental idiosyncracies and findings from psychotherapeutic exploration.
In writing a book which manages to temper clinical research with psychodynamic understanding, Peter Shoenberg redresses this balance. After a historical introduction that would have delighted the psychosomatists of fifty years ago, Psychosomatics provides brief summaries of diagnosable conditions sensitive to the psychodynamics that are frequently encountered. Unlike the earlier psychosomatists, he is able to set out the prospects for benefit from a broad range of psychotherapeutic treatments. According to Schoenberg, the main psychosomatic targets have become: stress; somatoform disorders; obesity and eating disorders and headache, as well as specific gastrointestinal, skin, cardiovascular, respiratory and musculoskeletal and gynaecological syndromes. Given the considerable psychiatric and psychotherapeutic literature on the earlier topics, the chapters on the last six kinds of systemic diso