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Psychosomatic Medicine, Vol 52, Issue 6 653-672, Copyright © 1990 by American Psychosomatic Society

ORIGINAL ARTICLES

The concept of somatization as a cultural and historical product of Western medicine

H Fabrega Jr
Department of Psychiatry, University of Pittsburgh, School of Medicine, PA 15213.

Somatization is handled as a concept that plays an important role in the contemporary clinical theory and practice of psychiatry and general medicine. A distinct biomedical epistemology and model of illness underlies use of the concept and gives it meaning. First, the nature of the assumptions about the medical problems described by the concept are outlined. Then, some of the cultural and historical aspects of Western medical history that shaped the concept and its epistemology are reviewed. The concept is seen to arise as a consequence of the development of the modern ontological view of disease, the shift in the role ascribed to the nervous system and theoretical developments involving the explanation of psychoses through a descriptive language of psychopathology and bodily states. A discussion of non-Western perspectives of illness is pursued in order to highlight the differences in the conditions that led to the evolution of the concept in Western medicine. Some of the theoretical quandaries associated with the concept are briefly reviewed.


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