THE SIGNIFICANCE OF INTERACTION IN BEHAVIORAL MEDICINE

The notion that social and psychological processes may influence somat ic illness is not new and not a product of our time. Already Aristotel es expressed his awareness of the need for social and mental well-bein g for the prospects of a long healthy life. With the progress of natur al sciences, however, with new revolutionary discoveries, like that of bacteria, antibiotics, insuline, etc., reductionism was also introduc ed into the research process. An unfortunate consequence was the lack of overview, the failure to see links between various research fields, between various research paradigms and between various research tradi tions. Whereas the Ancient Greeks were intuitively positive that body and mind constantly influence each other, scientists of the last centu ry have promoted the view that bodily functions can be objectively stu died, but that the functions of the mind are best captured by beliefs and religion. However, thanks to interactive initiatives from such,,ha rd'' discipline as neurobiology, physiology, neuroendocrinology with m ore,,soft ware'' disciplines like psychology, psychiatry, sociology, l earning sciences etc., we are beginning to adopt an entirely new persp ective on disease processes. This development has become possible beca use the need for interaction between scientists of various disciplines became so obvious. This led to the development of new research method ology, which combined elements from various,,soft'' and,,hard'' discip lines. The methods to examine stress reactivity is one example. A ment al stressor is standardized in a laboratory setting and bodily respons es are objectively assessed. This methodology enables us to investigat e to what extent an individual is inclined to react to a stressors in a presumably noxious fashion. Typically, we donxt know whether the str ess reactivity pattern is harmful in a long term perspective, on a day basic. Thus stress reactivity scientists would need help from and int eraction with epidemiologists and social scientists to determine how m uch impact this pathogenic mechanism could possibly have on the occurr ence of disease in the population. Another new perspective is created by the introduction of the concept of interaction into theory on causa tion. E.g. the potential to understand psychosocial or psychosomatic d isease processes has greatly increased by the simple paradigm of consi dering the effects of stressors of the social environment in the conte xt of specific personality characteristics. One such example is the st rain of social isolation, which seems to be considerably stronger in i ndividuals with a specific set of characteristics, the so-called Type a Behavior, than in individuals without such behavior, Type B individu als. This interactive model helps to explain some of the inconsistenci es in findings from various studies of personality and behavior type p atterns. Last but not least we have improved our possibilities and pot entiated our perspectives by the rapid increase in interaction across nations. Comparisons across cultures will greatly enhance the possibil ities to understand disease processes, once they are systematically an d objectively performed. All these options for interactive efforts pro mise to underscore the role of this field of research, which deals wit h the interface between body and mind. In that context I believe it is unimportant whether we call it psychosocial medicine, behavioral medi cine or psychosomatic medicine. The importance lies in the fact that w e need to strengthen our efforts to interact on a theoretical level, o n a practical level, on a methodological level and on a personal level .