Expectation for Psychosomatic Medicine of a New Era

Abstract

I joined the First Department of Internal Medicine after graduating from Nihon University School of Medicine in 1976 and had the opportunity to receive training of psychosomatic medicine in Kyushu University in 1978. Since then I have devoted my whole life to psychosomatic medicine. I have been involved in the clinical investigation of chronic pain, fibromyalgia, rheumatic diseases, bronchial asthma, COPD, and chronic fatigue syndrome. With a background of specialty of internal medicine, rheumatology and respiratory medicine, I was also involved in the basic research in the stress related physiological responses and biological defenses as a main theme of the study. From 1982 to 1985, I studied as a research fellow at the Cleveland Clinic in the United States and confirmed the value and importance of basic research for psychosomatic medicine through the study of molecular biology and immunology. I have sought to build up my professional skills of medical psychology such as autogenic training, transactional analysis and cognitive-behavioral therapy. I also had good opportunities to learn together with many psychology experts. I was inspired by the most important basic principle of psychosomatic medicine “Therapeutic Self” which has been sublimated into a treatment philosophy based on Japan’s unique culture. I was strongly encouraged by the belief that psychosomatic medicine is the pioneer in the future of medicine. On the other hand, times have been transforming drastically, and variable issues not covered by the traditional concept and model of psychosomatic medicine have been revealed. We must investigate more widely and deeply the possibility of development and contribution of psychosomatic medicine required by the modern society as the times change. We need to work from a global perspective on the pathologies of recent social problems and events associated with computerization and rationalization. We must also focus on vast mental deterioration such as depression, lacks of empathy, cooperation, emotional response and weakened relationships. With the use of advanced latest technologies, fundamental researches in the field of psychosomatic medicine are also unlimited such as seeking the differences in DNA sequences and gene expression modulated by environmental factors, analysis of protein-metabolite proteome and metabolomic analysis, immune modulation by oral bacterial flora in the gut and brain, neuroimaging studies on neural activity and discovery of biological markers. These accumulations of knowledge may be contributory to elucidation of the pathogenesis and mechanisms of many stress-related phenomena and disorders such as chronic pain, chronic fatigue, MUPS (medically unexplained physical symptoms) and FSS (functional somatic symptoms). I believe the congress was closed fruitfully and gave us a good opportunity to think of a new era of psychosomatic medicine.