The readings assigned in the last two weeks show that patients' attitude toward their own illness can be tremendously varied. In fact, it spans the full spectrum. Thus, without realizing it, Parkinson's patients described by Schupbach et al., internalized their illness and incorporated it into their persona, much like Witty Ticcy Ray. In contrast, the piece "Hearts and Minds" presents evidence of a kid, Benjamin, who did not want to be viewed as different in any way from his healthy friends. What's the reason for such different attitudes?
One possible reason in this particular case is both the age of the patients and the nature of their illness. Benjamin's cerebral palsy caused him a severe impediment in movement which at his age of six probably made it very difficult for him to participate in many games of other children. Resisting the effects of illness and playing with other kids whenever he could was probably the only way to stay friends with his peers. Although I'm not sure about this, my intuition is that Parkinson's patients were much older and didn't feel as strong a need to hang out with their friends as Benjamin. Like many people at that age, they were content with the social environment that mostly, or even entirely, consisted of their families. As a result, there was no real threat of being ostracized, at least not by the people "who really mattered" - their loved ones. On the contrary, the vignettes make it clear that the illness often strengthened the bond with their families; their battle with it was the source of respect and admiration in the outside world.
Regardless of what the source of the difference is, the bottom line is that we will see two very different attitudes toward illness (which require two different biopsychosocial treatment approaches) depending on the disorder, patient, and probably a host of other factors. Unless most doctors are natural psychotherapists (which, from my experience, most of them are not) it almost seems that every medical care provider needs to have at least some training in clinical psychology to be able to find a good psychosocial treatment strategy. The article about somatoform disorders left me with the same impression.
What are we to do? Changes in the medical school, nursing program, (and possibly neuropsychology doctoral program?) curricula? Or should a psychologist be an integral team player during in treating many disorders that so far have been considered "purely medical"?