Mind – body – environment

George Engel's psychoanalytic approach to psychosomatic medicine

Taylor, Graeme J. Professor

Department of Psychiatry, University of Toronto and Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1 X 5, Canada. Email: [email protected]

Received 30 October 2001; revised 18 January 2002; accepted 22nd January 2002.

Australian and New Zealand Journal of Psychiatry 36(4):p 449-457, August 2002.

Objective

To provide an overview of George Engel's psychoanalytic approach and contributions to psychosomatic medicine.

Methods

Engel's publications were reviewed to identify his use of psychoanalytic methods and concepts to explore and conceptualize the interrelationships among mind, body and environment in health and disease.

Results

Engel's contributions include an interviewing method for accessing psychological data; insights into the psychobiology of anaclitic depression; a psychosomatic theory concerning the influence of relationships and loss on susceptibility to disease; an elucidation of psychodynamic factors in the pathogenesis of chronic pain; and a longitudinal self-analytic study of anniversary reactions.

Conclusions

Engel successfully bridged the disciplines of medicine, psychiatry, and psychoanalysis, and broadened the scope of psychosomatic research and clinical practice by identifying the role of interpersonal relationships throughout life in regulating mental and bodily processes.