Over the last 20 years, medical researchers from a variety of disciplines, including behavioral medicine, neuro-immunology, neuroendocrinology, social medicine, and psychiatry, have converged in an effort to produce greater understanding and acceptance of the effects of psychological factors on physical health. Many in the medical profession have remained somewhat skeptical, claiming that psychological components of healing are largely “folklore”, unsubstantiated by hard evidence. The proponents of psychological factors have, in turn, criticized this skepticism as being unwarranted and dogmatic. Our goal is to go beyond this debate in an attempt to clarify the idealogical and historical roots of this impasse. Such clarification is essential because underlying the debate is a broader and more fundamental question about what is an acceptable medical model and, more specifically, by what criteria we may judge “hard” evidence. Without bringing these larger issues into focus, little progress will be made in reaching consensus on the relevance of psychological factors to mainstream medical practice.
Debates about the validity of research in the mind-body field often fail to produce any consensus. The way we define “validity” depends on, and changes with, our models of health and medicine. Our current model is constructed so that such nonmaterial, nonreducible, nonuniversal elements as psychological and social factors are, by definition, “soft” and, therefore, invalid. Proponents and opponents of incorporating psychological factors more fully into medicine reach an impasse, not primarily because they disagree on their analysis of research in the field, but because they are operating from different models.
