Like other cultural phenomena, psychosomatic illnesses are subject
to changes in fashion; here, Shorter (The Healthy Century, 1987,
etc.) has applied his considerable skill in researching medical
history to an examination of these trends from the mid-18th century
to the present. Shorter defines psychosomatic illness as "any
illness in which physical symptoms, produced by the action of the
unconscious mind, are defined by the individual as evidence of
organic disease and for which medical help is sought." He
identifies doctors' attitudes and beliefs as major cultural factors
in determining what symptoms the unconscious mind selects, and
examines how doctors' ideas have changed as new theories about
disease have evolved. He also looks at the changing doctor-patient
relationship over the past two-and-a-half centuries, making clear
why "the vapors" and hysteric fits of paralysis, once especially
common among women, are now quite unacceptable (as are the horrific
treatments devised by some doctors to deal with them). Shorter
notes that today chronic fatigue syndrome (CFS) is perhaps the most
fashionable psychosomatic complaint in a spectrum that includes
yeast infections, food allergies, and what has been called the
"twentieth-century disease," or "total allergy syndrome." Using CFS
as an example, the author traces how a psychosomatic illness
becomes fashionable as the mass media, supplanting medical
authority, disseminate pseudoscientific information about genuine,
difficult-to-diagnose organic diseases to suggestible individuals
with quite different symptoms. Whereas the "stifling intimacy of
family life" in Victorian times increased the propensity for
certain psychosomatic illnesses, he explains, today social
isolation and exposure to media sensationalism produce others. A
fine, example-filled account of how different times and different
mores produce different psychosomatic illnesses. (Kirkus Reviews)
In the 19th century, when gender roles were more confining, the
dominant forms of psychosomatic illness were paralysis and
hysteria. Today, when people experience confusion about the
abundant possibilities available to them, when all is permitted,
the dominant complaint is fatigue. Edward Shorter's history shows
how patients throughout the centuries have produced symptoms in
tandem with the cultural shifts of larger society. He argues that
newly popularized diseases such as chronic fatigue syndrome are
only the most recent examples of patients' ailments that express
the deepest truths about the culture in which we live.
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