Cartesian dualism and psychosomatics.

Ajarring surprise greets the reader of 20th century psychosomatic literature who comes to it after having been immersed in 17th and 18th century materials. The mind-body dualism credited to Descartes is referred to with uncommon frequency and is usually said to have exercised an overwhelmingly negative influence on modem medicine. Roy R. Grinker, for example, bitterly blames Cartesian dualism for separating the "mind as subject from body as object and creating a dichotomy that even now blocks unitary concepts" (p. 69).1 Many similar references in the literature exhibit the characteristic features of a shared mythology.2-4 Rather than presenting a nuanced and unfolding interpretation based on fresh readings of the primary historical texts, modem authors in the field ofpsychosomatics regularly repeat stock phrases and offer minor variations of identical interpretations. Descartes is depicted as a villain whose dualistic theory sharply separated mind from body, leaving an earlier holistic medicine in disarray.s By contrast, modem psychosomatic theory is portrayed as an effort to restore organismic theory to the position it occupied in classical medicine. The existence in modem psychosomatic literature of ideas that strike a student of the 17th and 18th centuries as a "Cartesian mythology" raises several important questions. For if the true historical Descartes and the mythic Descartes differ substantially, what purpose-not necessarily conscious-does this mythological reconstruction serve for American psychosomaticists? Why are they so attracted to a particular, antiheroic version of medical history? What ideological and emotional needs does it serve? This brief essay cannot possibly answer all of these questions, but it can suggest a plausible approach to their resolution. First we must turn back to the 17th and 18th centuries and pursue the true historical Descartes.