Johann Christian August Heinroth: psychosomatic medicine eighty years before Freud

Abstract

Most often it is assumed that the 'psychosomatic' concept originated from psychoanalysis. However, this term had already been introduced into medical literature about 80 years before Sigmund Freud - namely by Johann Christian August Heinroth, the first professor of psychiatry and psychotherapy in the western world. Widely through quotations from his works, the authors analyze Heinroth's understanding of the interrelations between the body and the soul. For Heinroth both formed a unified, indivisable whole, which interacted in many ways, including pathologically. According to him, a mental illness had its cause in the patient's leading a 'wrong life'. This 'wrong life' deranged the soul from its normal functioning. In a second step, this derangement can have an impact on the body and produce the somatic symptoms that accompany a mental illness. Since both 'components' of the 'indivisible whole' were affected, it was clear for Heinroth that doctors needed to view their patients holistically and treat the whole person. Since in the end the somatic symptoms were caused by an underlying mental derangement, this needed to be treated in the first place - and the psyche could only be reached by direct psychological intervention. Hence what he called his 'direct-psychische Methode' ought to be the remedy of choice for mental illnesses. Through his clear understanding of the interactions of body and soul and by integrating somatic and psychological therapies into a holistic, unified treatment programm, Heinroth is of major importance for the history of psychosomatic medicine.