The mind/body problem in contemporary healthcare

The rise of scientific or ‘biomedicine’ as a major aspect of the enlightenment process has bestowed enormous benefit such as increased life expectancy and protection from infectious disease, at least in the so-called ‘developed’ world. By the 21st century, diagnostic categories have expanded greatly, not least with the patterning of health and illness associated with longevity and emotional/mental health, demanding multifactorial aetiologies which require traditional categories, formulations and management strategies to be re-evaluated. Critiques of biomedicine and the process of medicalisation have emphasised the limitations of conventional scientific medicine in the separation of mind and body, hence the turn to more holistic or integrated models of health and illness, which are now permeating many areas of medical education and healthcare practice. Conditions with 'medically unexplained symptoms' such as chronic idiopathic pain syndromes; eating, sleeping and anxiety disorders, emphasise the limitations of the divisions between mental and physical health in the intertwining of emotion and embodiment. Although those who suffer such conditions may experience severe and distressing symptoms, traditional biomedicine may be unable to provide appropriate ‘care’ to alleviate them. Using the example of chronic pain, this chapter considers whether developments in the conceptualisation and treatment of pain have resulted in a paradigm shift which in turn address the mind-body dilemma in healthcare.