RESPONSE TO "BODY AND MIND"

One of the topics that can produce almost endless circular discussions is
the mind-body question. I hope it will not do so here. I want to say
something about it nevertheless. Patients who hear and believe their
illness is psychic, often feel that this means, they have in fact in one
way or another wanted it, and to believe that must be tormenting. The
"psych"-people don't always pretend to say that, but sometimes they do.

Now the qestion itself: can PD be caused by psychic problems. To answer
that straightforward: "nobody knows". I want to say more about it, hoping
to make it easier for people who can't stop blaming theselves.
>From some other patients I heared they where referred to a psychiatrist
because of their not-recognised PD symptoms. As soon as the psychiatrist
seriously thought the diagnosis PD could be the right one, they were
referred to a neurologist. I never met nor heard of a psychiatrist who
pretended he could cure PD or could treat the symptoms as good as the
results l-dopa gives. This does not of course exclude a psychic cause.
Let's take a look at the arguments.
One is given by people who say they get the impression seeing PD's, that
they are rigid, tense, introvert, not verry happily going through life
charactres. This argument is not at all impressive knowing one of the
tragic aspects of PD. PD's, due to the illness itself, do express their
emotions less facially and in the way they move. If one wants to know how a
PD is on the inside, one can trust ones intuition less than in normal
circumstances. This is extremely difficult. This lack of expression is a
tragic aspect of PD.
The heaviness of the symptoms is dependent of the state of the disease and
(among others) the emotions of the moment. Knowing that, it seems logical
to people to say PD is psychic. But by calling the emotions of the moment
the cause of the illness, one states that these emotions are pathological
and need treatment. Being tense, angry, sad or upset as a reaction on
events is of course quite normal. This is the same I suppose Mary Anne
said.
Just another thing: patients or their relatives tell regularly the PD
started after something traumatic happened. This relates to the emotion-
symptom thing. I have to tell a short story about myself to make this
clear.

I was diagnosed PD in november 1984. About half a year before I had, just
once, a freesing reaction: my whole body got stiff and I felt as if I was
made of wood. It was a Sunday about 5 o'clock p.m. I had just started
cooking whenn my 10 years old daughter came home, crying loud. She had
fallen off her bike and got a rather deep and dirty wound on her chin. The
place of the accident is much used by people walking their dog. Pooper-
scoopers don't exist in Holland. So, I had to go to a hospital as soon as
possible. My husband was not at home. I had no car. Stress runs high at
such a moment. Some time later a neigbour drove us to the howspital. At
that moment I had this strange reaction which I could not give a name at
that time but recognised half a year later. Just an hour had passed when we
were driving home again, the wound professionally claened and stitched. My
strange stiffness had disapeared and waited months before coming back.
I suppose had the accident of my daughter been serious, and had I been
upset a much longer time, the Parkinson Disease would have surfaced much
more evidently. The conclusion that the disease was caused by a traumatic
event would have seemed inevitable.

Even if a causal relation exists between stress and PD it can only be a
very vague one. As was said by someone else in this discussion, people can
live extremely stressfull lives without ever having a trace of PD.
 Margaret Tuchman referred to findings in which people with PD. reported more
adverse childhood circumstances then those without PD. Maybe this differen-
ce in reporting comes from real difference in events. From experimental
psychology however we know that people who are depressed report more
negative about their childhood than when they are not depressed and
depression is more frequent in PD's than in non-PD's.

In my opinion the conclusion seems to be: the belief in a psychic cause is
like a belief in reincarnation. It can't be proven at all or being made
likely, but it can neither ever be proven untrue. The belief in psychic
cause is not always harmless. As an analogy: the thinking about schizofre-
nia in the seventies has done much harm, blaming the parents. Now that the
possibilities of farmacologicel treatment have so much inproved and the
help of parents can be so usefull in creating stable circumstances of
living, the accusing attitude they had to endure in the seventies seems
very cruel. After all, if a disease comes not from stress of the here and
now but is due to childhood conflicts, it can be highly incurable.

I read a dissertation about PD. The autor is a neurologist who believed in
the psychic cause of PD. He wrote he had never seen a woman with PD who had
ever had any happiness in life.
I felt offended. I have learned something about his view on women.
In my opinion he can't have had a nice mother, but of cause I can't prove
that.

                                                  Drs. Ida Kamphuis
                                                     psychologist