In the musical Guys and Dolls, the character named Adelaide has a psychosomatic cold. As she explained,
The average unmarried female
due to some long frustration may react
with psychosomatic symptoms
difficult to endure
affecting the upper respiratory tract.
Guys and Dolls is a quaint artifact from the 1950s. Nevertheless, the American Psychiatric Association’s Diagnostic and Statistical Manual still gives doctors permission to say, “It’s all in your head” if they can’t immediately figure out what’s wrong with you. An article of mine that was published in the journal Medical Hypotheses says that doctors cannot make that kind of diagnosis without making an error in reasoning. For that reason, I argue that the APA should remove conversion disorder and somatization disorder from the DSM. The fifth edition of the DSM (DSM-5) is due in 2013.
Many laymen and even many doctors like the idea that people can give themselves a serious physical disease just by having bad thoughts, unpleasant feelings, or annoying personality traits. Yet it’s hard to find any scientific evidence that these psychological phenomena have any real effect on health. Nevertheless, the attempt to “psychologize” physical illness persists.
Although many people like the idea that their thoughts can influence their health, people can be amazingly resistant to the idea that their food choices matter. If I were a psychologist, I would use my training to figure out why our doctors in the United States ignore the overwhelming evidence that the standard American diet is the underlying reason for our major causes of death and disability. I’d try to figure out ways to help people realize that they’re eating their way into an early grave. I’d try to find ways to help people improve their diet, so that they can improve their health. Instead, psychologists have been trying to prove that coronary artery disease is a mental disorder. It would be funny if it weren’t so tragic!
By the end of World War II, anyone with common sense and access to the scientific literature should have realized that coronary artery disease results from the foods that people eat, not from the kinds of thoughts and feelings that go on in their minds. For example, heart disease became rare in Norway after the Nazis stole their farm animals and the Norwegians had to switch to a low-fat, plant-based diet. Rich, fatty foods were also in short supply for the civilian population in Germany during the war. As a result, German civilians stopped dying of heart attacks, despite all the stress and terror of Allied bombing raids.
After seeing these data, Nathan Pritikin realized that heart disease results from the foods people eat, not from the emotional stress in their lives. When he got a diagnosis of coronary artery disease, he cleaned up his own diet and encouraged others to do the same.
Nevertheless, Americans still clung to the idea that heart disease is a mental disorder. First, people thought that the cause was “emotional stress.” Then they blamed “type A personality.” Then they blamed “pessimism.” It’s all a crock. Lots of people in China had emotional stress, type A personalities, and pessimism. Yet research showed that they weren’t dying of heart attacks, because their average cholesterol was shockingly low by American standards, thanks to their low-fat, high-fiber diet.