Pain Psychology: “Psychosomatic Medicine, Behavioral Medicine, Just Plain Medicine”

“Psychosomatic medicine, behavioral medicine, just plain medicine”, title of the 1986 Presidential address to the American Psychosomatic Society by Professor Bernie Engel of John Hopkins and NIH, came at a time when traditional constructs such as the dualism of mind and body in health and disease and the ‘black box’ of behavioral inputs and outputs were being eroded by investigations of behavioral neurophysiology and the impact of cognitive processes on emotions and behaviors and their impact on health. Engel said, “Neurally mediated physiologic responses fulfill all of the criteria for behavior and obey all of the laws of behavior subject to the anatomic and physiologic constraints inherent in their structures and functions. It is illogical and wrong to assert that neurally mediated responses interact with behavior. THEY ARE BEHAVIOR (Dr. Engel’s capitalization). These principles are a legitimate and necessary part of the training of all medical students, residents, and fellows [1].”Finally this moment has arrived, with widespread recognition … rgallagh{at}mail.med.upenn.edu