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Brain-gut axis as an example of the bio-psycho-social model
  1. I Wilhelmsen
  1. Department of Internal Medicine, Deaconness Home Hospital, University of Bergen, 5009 Bergen, Norway
  1. Professor I Wilhelmsen. Ingvard.wilhelmsen{at}meda.uib.no

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In research we often apply hypothesis testing which assumes a linear, causal relationship between two or more factors. This is a valid way of testing fragments of a complicated chaos of known and unknown elements. However, I want us to reflect upon the thought that the answers we get are limited by the questions we ask. It is said that “If you have a hammer, the only thing you see are nails”. Western medical education and research has, for more than a century, been dominated by a dualistic view of human nature, and from the psychoanalytical tradition (based on Freud's work) we have learned to differentiate between biological (physical, organic, somatic) on one side and psychological (thoughts and emotions) on the other. This dualistic view, emphasising that psychological and biological are two entirely different aspects of human life, is mechanistic and reductionistic, and in today's world a non-scientific position to hold.1 In spite of many decades of research, there is no evidence that emotions can “pile up” somewhere in the body and that psychological conflicts, if unresolved, are converted to somatic symptoms or diseases. On the contrary, science is moving into a position of integration, and the cognitive science (such as neuroscience) has developed rapidly in recent years. You cannot experience an emotion or think a thought without biological correlates. Unresolved mental conflicts lead to activation of the central nervous system (CNS), and of the autonomic systems. Activation theories, such as the “cognitive activation theory of stress” states that the stress response is the same as activation—a general alarm system operating whenever the organism registers that there is a discrepancy between what is expected and what really exists.2 The brain-gut axis is a good example of a circular relationship between different factors, and illustrates that research on interrelationship …

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