The Explanatory Model Difference Of Somatization Phenomena In Chinese And Western Culture

Somatization or somatizing of psychological problems refers to a reaction tendency of mental problems, by which people express body distress instead of psychological discomforts. Somatization phenomenon has significant differences between nations, ethnics and cultures. Clinical practitioners and researchers are often encountered problems causing by cultural background issues. As an illness phenomenon, somatization has two core characteristics:1) psychological discomforts transfer into physical illness, and2)"medically unexplained symptoms." From the perspective of illness experience, the meaning of somatization is "physical symptoms with no reasonable physiological cause in medicine and therefore assumed to be caused by psychological factors". However, under Chinese and Western culture, there are many differences and disagreements in the explanatory models of similar illness. That makes on reason why the conception of "somatization" meets difficulties in clinical practice.The paper focuses on the explanatory model differences of illness in different cultures’medical system, and studies the cultural difference of somatization phenomenon from the perspective of medical philosophy by analyses the basic ideas of Chinese and Western medical system. The cultural differences of somatization may be due not only to the illness experience differences between Chinese people and Western people, but also to the problem of the explanatory model which now be called somatization. And this problem does not only come from the cultural adaptability caused by the ideas conflict between Chinese and Western culture, but also from the conflict between somatization conception and the Western scientific system which it roots in. So, to study the problems somatization encountered in practice through analyzing the explanatory model differences in different cultures and times will help to further understand the context and causes of cultural issues of somatization phenomenon and to provide some reference and basis for clinically solving disorders and diseases related to somatization. Firstly, the paper analyzes respectively how Chinese traditional medical system and Western experimental medicine system explained the unexplained somatic illness. On the basis of local unique ideas of body, illness and treatment, traditional Chinese medicine established a kind of illness models to explain distress experience which "somatization" refers to. These models have many common features which are different with the explanation models of the Western experimental medicine on classification and diagnosis. In the West, as the birth of experimental medicine, the understanding of such issues had been greatly changed:mechanical body-mind dualism of rationalism and scientism led to the emergence of psychiatric and the independence of psychological categories. Medicine in an orthodox way focuses on body lesions with detectable biochemical processes, while the "medically unexplained symptoms" were attributed to explanations of a psychological way. In the competition with the neurophysiological explanatory model, psychogenetic "somatizied" explanatory model prevailed and became today’s mainstream model to explain "medically unexplained symptoms". Psychiatry then further expanded the somatization kind disorder gradually to make it an independent diagnostic category, but in the process caused the conflict of psychiatry and general medicine.The paper then analyzes the reason why the explanatory models of somatization phenomenon are different in Chinese and Western culture. First, the ideas of Chinese traditional medicine and all the pre-scientific ideas in other cultures had common features. The differences of explaining the somatization phenomenon between Chinese traditional medicine and Western medical science is partly due to the general differences in pre-scicntific and scientific explanatory models, not all come from differences of Chinese and Western culture. And nowadays, because of the modernization of social system and way of life in China, Chinese medical ideas and practices have gradually been assimilated Western model. At the same time, the somatization concept also has a contradiction within the Western medical science system, which reflects the contradiction and competition of psychiatry and general medicine in the middle ground between physical and mental field. The somatization concept in essence tried to cross the boundary of mind and body duality, but the "mental energy conversion" theory it relies on lacks scientific legitimacy. So in scientific sense, somatization was reduced to the level of various local syndromes of traditional cultures, making its cultural inadaptability became more prominent. The somatization concept conflicts and competes with both the traditional explanatory model and general medical explanation model, make it meets difficulties whether in China or the West.Finally, the paper makes theoretical assumptions of the integration of somatization explanatory models according to the conclusions of psychosomatic medicine, neuroscience and other research. Currently, findings in neurophysiological and cognitive levels related to somatization phenomenon may contribute to the integration of physiological and psychological explanatory models. On the other hand, from a practical perspective, the ultimate goal of medicine is to treat illness. In clinical practice, which explanatory model the doctor should use should be judged by its ability to guide more effective treatment methods. Using certain factors of traditional models in practice may play a certain effect in some conditions which the science is still incompetent. An important question needs further study is how to make better use of traditional medical explanatory models in modern medical system. The author argues that we should use different explanatory flexibly and reasonably according to the clinical utility to understand and deal with psycho-somatic distress like somatization.