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Dialogue: a link to psychosomatic illness

JAMA. 1982;247(20):2760. doi:10.1001/jama.1982.03320450006003.
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The underlying causes of psychosomatic disease may lie in a person's dialogues.

"Dialogue," in this sense, according to Aaron H. Katcher, MD, associate professor of psychiatry at the University of Pennsylvania School of Medicine, Philadelphia, is a term used to sum up the complex interactions between a person and his environment. Untoward physiological consequences of these interactions range from migraine and hypertension to irritable bowel syndrome.

Until fairly recently, there was no satisfactory way to actually demonstrate such effects, Katcher and other investigators told a symposium on "Healing Interaction: The Physiology of Human Communications," sponsored by the medical school's Department of Psychiatry and The Center for Family Studies, Philadelphia. Now, however, a new understanding of the autonomic nervous system is being facilitated by such techniques as computerized blood pressure (BP) monitoring.

The latter is a specialty of James Lynch, PhD, professor of psychiatry and director of the Psychophysiological Clinics at


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