Developing a Psychosomatic Imagination in Medical Students and Psychotherapy Trainees

How can we help medical students and psychotherapy trainees to develop an awareness of the mind in relation to the body, so that both can develop a psychosomatic imagination? This is an exploration of some of the difficulties that medical students have in appreciating the role of emotions in illness and of the difficulties psychotherapy trainees have in considering the importance of the body in psychotherapeutic work with patients with physical symptoms. Student Balint discussion groups and student psychotherapy schemes give clinical medical students the opportunity to explore their own and their patients’ emotional reactions to illness and to learn about the interplay of emotions with the body in physical illness. The Royal College of Psychiatrists is now encouraging the development of such Balint groups and/or psychotherapy schemes in all UK medical schools. Psychotherapy trainees studying the effects of emotions in psychosomatic illnesses often have difficulty in learning how to interpret physical symptoms that occur in psychotherapy. They tend to want to see such symptoms as having symbolic meaning and find it hard to appreciate the medical logic of physical illness. It is important that some medical understanding of these conditions is also included in seminars on psychosomatic conditions.