Psychotherapy applied to medical pathologies: perspectives of a medical science with the soul

Juvenile diabetes

I am a doctor and I am also a psychotherapist. One of my goals in recent years has been to combine medicine and psychology. Too often in practice there is a tendency to distinguish the areas of influence, in the wake of the distinction between mind and body hypothesized by Aristotle. But before Aristotle, it was Hippocrates who was the first physician, but also the first psychologist. He, who was Protagoras' grandson, used the persuasion techniques of Sophist philosophy, that is, the most ancient Western vestiges of modern psychology, to give a prescription. It is said that whenever he had a difficult patient he was accompanied to the sick bed by his uncle to persuade the patient to entrust himself to his care.

Modern technology applied to medicine has sharpened the distance between those who treat the sum and who takes care of the mind. Modern medicine has been invested to such an extent by technological innovations, that even the anamnesis and the old dear objective examination, that is the interview with the patient to collect his clinical history and the visit with the doctor's bare hands, are overshadowed. with the technical aid of the phonendoscope alone, which however are still valid diagnostic tools and also the cheapest ones. I know that in the eyes of the reader and even of some doctors this may seem a romantic attempt to re-evaluate things considered obsolete. But I can guarantee that technology has not yet supplanted the dialogue with the patient and the normal visit to the patient's bed.

In my practice as a psychotherapist, precisely because we talk to patients, I also happened to have to fight the diagnosis of tumor made by MRI and CT and after various diatribes to see me agree with my colleague surgeon on the eve of an already scheduled surgery.

A good interview can even dispel the diagnosis of pancreatic cancer, in the case in question, albeit made with the most advanced diagnostic techniques, with the consequence of sending a man back to his good retirement habits instead of in the operating room with a bad diagnosis. Precisely a medical science that knows how to use technology, but which preserves the soul, that is, the consideration of the patient's narrative, of his originality even in highlighting the symptoms or presumed symptoms of illness.

A field where the connection between mind and body, between speech and technique is evident, is in the chapter of psychosomatic diseases, where you can heal the body starting from the mind and where you can heal the mind starting from the body. Dermatological and immunological diseases are so many areas where psychotherapy can assist medicine in obtaining improvements or healings. The link between mind and body in metabolic diseases is particularly evident.

In the daily practice of psychotherapist there are already hundreds of cases of people who came to me for some psychological problem, once psychotherapy was successfully completed, they saw all biological parameters normalize. Thyroid hormones returned to normal, liver and pancreatic enzymes returned to the normal range, obviously documented with constant monitoring by colleagues endocrinologists and gastroenterologists. Nothing magical or illusory. The connection between the brain seat of the mind and the body is also clear from an anatomical point of view, just refer to the hypothalamus-pituitary-thyroid-metabolic organs axis: intestine, liver ...

In the wake of these reflections, in agreement with a hospital endocrinologist colleague, it was decided to quantify this connection. We chose to start with the Type I Diabetes, Juvenile Diabetes. Alongside studies on nano-technologies carried out by the colleague, in collaboration with the Italian Institute of Technology in Genoa, for the development of increasingly intelligent systems of perfusion with insulin, therefore alongside technological studies of excellence, on an experimental basis it was decided to work with a group of patients to combine Strategic Psychotherapy with medical therapies.

La Strategic Therapy Giorgio Nardone's model it is particularly suitable for collaborating with medicine because it is a pragmatic approach that aims to unblock rigidity of the Reactive Perceptual System, in the case in question related to the unexpected diagnosis of diabetes in the young and to have the peculiarity of working on the person's resources intact and potentially available to overcome the limitations imposed by medical therapies. The goal is not only to cure the disease, but to diagnose how the disease is inserted in the person's narrative, in his / her system of perception of reality and how the therapy, in order to work at its best, must be inserted in that narrative.

As the geneticist Sermonti explains, science proves to have a soul when it is inserted into a narrative, in this case the individual narrative, which is the patient's originality with his values. For example, treating an athlete means guaranteeing him the possibility of continuing the activity and having performance: the therapeutic lever is the sporting goal; a young woman may instead have the goal of motherhood.

From a strictly technical point of view we will carry out a longitudinal study, that is, we will evaluate the trend of the changes in metabolic parameters after psychotherapy in relation to the trend before psychotherapy and to the variation of the psychic attitude towards the pathology.

Subsequently, a cross-sectional research will be carried out: we will evaluate the trend of metabolic parameters in people treated with psychotherapy compared to patients treated only from a biological point of view obviously with the same age, socio-economic and cultural condition, diabetes compensation, weight, dietary behavior.

In a recent book, Fabrizio Benedetti, neurophysiologist at the University of Turin, established that words can assist drugs in curing diseases. Good words influence the secretion of neurotransmitters, also favoring healing processes from an organic point of view.

What we are going to experience is the influence of good words and good strategies on the clinical course of drug therapy and on the quality of life of medicalized patients. Psychotherapy will not be understood in a reductive way, as on the other hand it often happens, as a support to the medicalized patient, but as a complementary and integrated agent to the patient's overall therapy.

The study has recently been planned, but some group meetings have already been held with patients, who have been enthusiastic about the idea, testifying that when healthcare professionals propose something innovative not only from a technological point of view but also human consent and collaboration are guaranteed.

Dr. Andrea Vallarino
(Doctor, psychotherapist, official researcher and professor of the Strategic Therapy Center)

REFERENCES

Nardone, G .; Watzlawick, P., The art of change, Ponte alle Grazie, Milan, 1990
Sermonti, G., A science without a soul, Lindau, Turin, 2019 (first publication 2008)
Benedetti, F., Hope is a drug, Mondadori, Milan, 2018