Da medicina psicossomática à psicologia médica: a trajetória teórica e institucional de Julio de Mello Filho / From psychosomatic medicine to medical psychology: the theoretical and institutional trajectory of Julio de Mello Filho

Resumo Os estudos sobre as causalidades das patologias e da relação médico/paciente a partir de formulações psicanalíticas receberam duas denominações no Brasil: medicina psicossomática e psicologia médica. O médico e psicanalista Julio de Mello Filho assumiu o protagonismo dessa proposta a partir da doença incapacitante do psiquiatra e psicanalista Danillo Perestrello. A estruturação da concepção teórica do movimento psicossomático e as estratégias institucionais utilizadas para a consolidação desse campo disciplinar no cenário brasileiro são o objeto deste estudo. Por meio de um referencial epistemológico e histórico, conclui-se que a proposta inicial de transformação do modelo médico hegemônico perde força e observa-se um deslocamento da psicologia médica como um campo da psicologia da saúde.

Abstract Studies on the causality of pathologies and the doctor/patient relationship based on psychoanalytic formulations received two denominations in Brazil: psychosomatic medicine and medical psychology. The physician and psychoanalyst Julio de Mello Filho took a leading role in this movement after the psychiatrist and psychoanalyst Danillo Perestrello was incapacitated by illness. This study investigates how the theoretical concepts of the psychosomatic movement were structured and the institutional strategies used to establish this discipline in Brazil. From an epistemological and historical point of view, the initial notion of transforming the hegemonic medical model was seen to lose force, followed by a shift in medical psychology as a field of health psychology.

Evolución histórica de la psicología médica y su riqueza para la formación humanista y psicológica del médico general / Historical evolution of medical psychology and its wealth for the humanistic and psychological formation of the general practitioner

El objetivo de este artículo se basa en el principio de que el ser humano aprende de su pasado, de ahí que contar con la evolución histórica de la materia ‘Psicología médica’ enriquece la conciencia de quienes la imparten y fortalece sus raíces y las del Departamento de Psiquiatría y Salud Mental de la Facultad de Medicina de la Universidad Nacional Autónoma de México que la fundó, además de que establece las bases para proteger y fomentar su importancia dentro del currículo de la carrera de médico y da a conocer la materia a otras universidades que también consideran que es una asignatura indispensable en la formación de los médicos. Basándose en el análisis de diversas fuentes de información, se reconoce la importancia de sus profesores, de sus programas y del apoyo que brinda a la formación de los futuros médicos

This article is based on the principle that human beings learn from their past, hence having the historical evolution of ‘Medical Psychology’ course, enriches the conscience of those who teach it, strengthens their roots and those of the Department of Psychiatry and Mental Health of the Faculty of Medicine of the National Autonomous University of Mexico who founded it and, lays the basis for protecting and promoting its importance within the curriculum of medical career and makes it known to other universities that also consider that it’s indispensable in the formation of their doctors. Based on the analysis of different sources of information, it recognized the importance of their teachers, their programs and support provided for the training of future doctors

Luciano L'Abate (1928-2016).

This article memorializes Luciano L'Abate (1928 -2016). In 1964, L'Abate became an assistant professor of medical psychology at the Washington University School of Medicine and, in 1965, an associate professor of pediatrics in the Emory University School of Medicine. He then transitioned to the Georgia State University (GSU), where he was promoted to professor of psychology. From 1965 to 1990, he served as director of the Family Psychology Program and Family Study Center at GSU. In retirement, L'Abate increased his writing and lecturing. He made countless international presentations on child and family issues. He commonly collaborated with students and other mental health professionals in his research and writing projects, which resulted in approximately 58 books and dozens of journal articles. (PsycINFO Database Record

[The identity of medical psychology: a historical quest]. / Die Identität der Medizinischen Psychologie: Eine historische Spurensuche.

The starting point of this study is the current uncertainty in German-speaking medical psychology about its actual and very own natural area of expertise. The current study ventures to advance the hypothesis that part of this uncertainty is due to the fact that during the scientific area in its history (approx. 1850-1960) medical psychology abandoned its historical core competence as it emerged and developed during the age of enlightenment (end of 17(th)-18(th) centuries). To make this change clear, different examples of the 2 opposing conceptualisations of medical psychology are discussed, of course in a selected and maybe even provocative way. The change in concept also led to the fact that the interrelationships with and differentiation from its neighbouring disciplines are not clear and sharp either, since at times 2 or more disciplines declare themselves competent for one and the same thing. This is exemplified on the manifold overlappings with clinical psychology. Given the lack of resources now and in the future, this lack of a clear definition of competence might lead to continued uncertainty as well as to conflicts over distribution. On the other hand though, the look into the history of the subject reveals that at all times it has been a matter of individual approach or attitude as to what was regarded as core area of interest and competence of medical psychology and how far it overlapped with neighbouring disciplines. From the point of view of the history of psychiatry and on the basis of carefully selected historic material, this paper presents the core of 2 different concepts of medical psychology to elaborate this hypothesis.

[The history of the institutionalization of medical psychology in Austria]. / Zur Geschichte der Institutionalisierung der Medizinischen Psychologie in Österreich.

Beginning with Freudian psychoanalysis and the Zürich school of psychiatry, which in the early 20th century were the first to call for studies in medical psychology at universities, the article traces the path to the institutionalization of medical psychology in Austria especially in Vienna. Particular attention is devoted to the Academic Society for Medical Psychology (Akademischer Verein für Medizinische Psychologie) which held lectures and courses at the University of Vienna from 1926 to 1938. The Society can thus be viewed as a predecessor of the foundation of the institutes for medical psychology and psychotherapeutic clinics, starting in the late 1960s and continuing into the early 1980s.

The rise and decline of character: humoral psychology in ancient and early modern medical theory.

Humoralism, the view that the human body is composed of a limited number of elementary fluids, is one of the most characteristic aspects of ancient medicine. The psychological dimension of humoral theory in the ancient world has thus far received a relatively small amount of scholarly attention. Medical psychology in the ancient world can only be correctly understood by relating it to psychological thought in other fields, such as ethics and rhetoric. The concept that ties these various domains together is character (êthos), which involves a view of human beings focused on clearly distinguishable psychological types that can be recognized on the basis of external signs. Psychological ideas based on humoral theory remained influential well into the early modern period. Yet, in 17th-century medicine and philosophy, humoral physiology and psychology started to lose ground to other theoretical perspectives on the mind and its relation to the body. This decline of humoralist medical psychology can be related to a broader reorientation of psychological thought in which the traditional concept of character lost its central position. Instead of the focus on types and stable character traits, a perspective emerged that was primarily concerned with individuality and transient passions.

[Alfred Binet and the first 'measures' of intelligence (1905-1908)]. / Alfred Binet e le prime 'misure' dell'intelligenza (1905-1908).

Alfred Binet (1857-1911) is considered the most representative exponent of the second generation of French experimental psychologists. His scientific work was inspired both by the experimentalism that Théodule Ribot and Hippolyte Taine introduced in France at the end of the 1870s, and by that of Wundt. Drawing from numerous sources, Binet was able to elaborate a psychology that focused on experiments and a controlled observation of pathological phenomena, with the objective of differentiating them from normal phenomena. His scientific production was moreover characterized by the emphasis placed upon the experimental study of "superior" psychic phenomena and, in particular, on their measurement. The aim of this paper is to describe the stages and sources of the "psychological" study of intelligence, which constituted precisely the fil rouge that had indispensably to be followed in order to fully understand the originality of all of Binet's research, whose most mature product was undoubtedly represented by the development of the Echelle métrique de l'intelligence, the first intelligence test in the history of psychology.

Suicide research before Durkheim.

The casual reader could be forgiven for assuming that there had been little systematic research on suicide before the work of the French sociologist, Emile Durkheim, published in 1897. This historical review demonstrates that there had been extensive studies in the preceding centuries, addressing not only the importance of social factors, but also those factors which are now subsumed in the medical model. In fact, some earlier reviews can now be seen as more balanced and comprehensive than that of Durkheim. In the twentieth century. the predominant focus of suicide research was on the importance of psychosocial factors, a focus which was undoubtedly a legacy of the influential work of Durkheim. Indeed, in 1971 Alvin Alvarez stated that the study of suicide had become the subject of intensive scientific research. The change began in 1897 with the publication of Emile Durkheim's classic Suicide: A Study in Sociology, and more recently Alexander Murray noted that, if the study of suicide had its own era it would divide into two ages, before and after that book ... Le Suicide ... which, more than any other, established its subject as a specialization. Therefore it is not unexpected that many believe that there had not been any substantial suicide research before Durkheim, let alone any which had addressed illness and biological factors and their inter-relationship with society.

'Introspectionism' and the mythical origins of scientific psychology.

According to the majority of the textbooks, the history of modern, scientific psychology can be tidily encapsulated in the following three stages. Scientific psychology began with a commitment to the study of mind, but based on the method of introspection. Watson rejected introspectionism as both unreliable and effete, and redefined psychology, instead, as the science of behaviour. The cognitive revolution, in turn, replaced the mind as the subject of study, and rejected both behaviourism and a reliance on introspection. This paper argues that all three stages of this history are largely mythical. Introspectionism was never a dominant movement within modern psychology, and the method of introspection never went away. Furthermore, this version of psychology's history obscures some deep conceptual problems, not least surrounding the modern conception of "behaviour," that continues to make the scientific study of consciousness seem so weird.

[On the thinking of medical psychology in Pre-Qin Period].

There are abundant medical psychological thoughts in the ancient Chinese medical and cultural heritage. Based on the time of appearance of the above materials, it indicates that China is one of the earliest countries where medical psychology originates. There are systematic recognition and descriptions on the psychological factors as the etiology of diseases, and achievements on psychotherapy as well in the Pre-Qin Period. All these thoughts and achievements are basically identical with research of modern medical psychology. The theories are essential experiences of our ancestors about two thousand years ago. Today, these theories still play a significant role in guiding the clinical practices and scientific researches.

A "creative tension": the Royal Army Medical Corps and the interplay of psychological and physiological in the rise of a psychoanalytic synthesis, 1915-22.

Secondary accounts of the impact of the First World War on psychological medicine have traditionally painted a picture of psychoanalysis as the preserve of a small number of pioneering individuals, led by William Rivers and marginalized by a Royal Army Medical Corps (RAMC) obsessed with discipline. This view ignores the climate of theoretical exchange promoted by the RAMC's concern with returning as many soldiers to the front line as possible. The RAMC approach provided new resources and a positive environment for the rise of a psycho-physical psychoanalytic synthesis, to build on the extensive work in this field in which RAMC officers were engaged from a very early stage in the war. William Rivers, despite recent popular acclaim, stood at the rearguard of this movement, in which the varied and important work of William Brown is often overlooked.

[Contributions of hospital psicology to the care of the surgical patient]. / Contribuições da psicologia da saúde-hospitalar na atenção ao paciente cirúrgico.

PURPOSE: The present article show some contributions to the Health Psychology at the chirurgical patient attention, with the interdisciplinary intervention propose, under the biopsychosocial paradigm. METHODS/RESULTS: Show some points about the relationships above the chirurgeon, health team and patient and presents some psychological and psychopathologic answers to the patient under the trinomial illness-hospitalization-care in the period a long the diagnosis and chirurgical indication at the rehabilitation proceedings. CONCLUSION: Psicologist must conquist, by knowledge and dedication, his space in surgical teams.

Contribuições da psicologia da saúde-hospitalar na atenção ao paciente cirúrgico

OBJETIVO: O presente artigo discute algumas contribuições da Psicologia Hospitalar à atenção ao paciente cirúrgico, utilizando como pressuposto as propostas de intervenção interdisciplinar em saúde dentro do paradigma biopsicossocial. MÉTODOS E RESULTADOS: Apresenta aspectos relacionados à relação cirurgião-equipe de saúde-paciente e elenca alguns processos de respostas psicológicas e psicopatológicas do paciente frente ao trinômio doença-internação-tratamento no período que vai do diagnóstico e indicação cirúrgica até a fase de pós-operatório tardio e reabilitação do paciente. CONCLUSÃO: o psicólogo instrumentalizar-se adequadamente para conquistar, pelo seu conhecimento, pelo valor de seu trabalho e pela sua dedicação, seu espaço dentro das equipes cirúrgicas.

[Willy Hellpach's (1877-1955) Medical Psychology]. / Die Medizinische Psychologie Willy Hellpachs (1877-1955).

In Germany Medical Psychology was commonly understood as Psychopathology until the mid-20th century. Especially Ernst Kretschmer (1888-1964) and Paul Schilder (1886-1964) can be named as authors who contributed to this particular field representing a basis of psychiatry. With his textbook 'Klinische Psychologie' published in 1946, Willy Hellpach (1877-1955), a neuropsychiatrist and professor of psychology, established a new understanding of this part of Applied Psychology. His statement: "All forms of mental behaviour in somatic diseases are subject of Clinical Psychology " has fallen into oblivion. Although presented as Clinical Psychology has conception is basically medical-psychological. We intend to outline Hellpach's biography and to describe - thereafter - the development of his Clinical, i.e. Medical Psychology and its subjects. We hope that medical psychologists, especially in Germany, but in other countries, too, will absorb Hellpach's ideas and will begin to appreciate his importance for the configuration of a modern Medical Psychology.