Directions: You are expected to study this section in class. Don’t preview.

Word Pretest

For each italicized word or expression, choose the best meaning below.

1. His flushed look was only one manifestation of his fever.
A. evidence B. result C. defense
2. I’ll tell you my favorite remedy for a cold.
A. recipe B. cure C. improvement
3. This statement was a classic illustration of British politeness.
A. typical B. rare C. traditional
4. Hope and fear alternate in my heart.
A. occur by turns B. rise C. die away
5. He tapped his finger on the desk subconsciously.
A. deliberately B. secretly C. unintentionally
6. His music conveys a sense of optimism.
A. communicates B. converts C. conceals
7. I wish he would snap out of his present mood.
A. break away from B. get out of C. get quickly into
8. She made elaborate preparations for the party, and then no one came.
A. deliberate B. fancy C. careful
9. Cheating deserves our harshest condemnation.
A. praise B. disapproval C. recognition
10. If you persist in breaking the law, you will go to prison.
A. continue B. stop C. startS

Key: 1. A 2. B 3. A 4. A 5. C 6. A 7. B 8. C 9. B 10. A

Text A

1. Background Information
2. Text: The Interaction of Body and Mind

The concept of psychosomatic illness
　　Psycho, refers to mind, and soma, to body. Psychosomatic illness is the occurrence of bodily symptoms which are psychological or emotional in origin.
　　Mind and body are not separate, one affects and is affected by the other. Who has not experienced some physical manifestation of emotional stress? Such experiences as a headache after a quarrel and urinary frequency or diarrhea before an examination are not uncommon, and for most people they are of a temporary nature. The symptoms disappear and are forgotten after the crisis has passed. No treatment may be needed, or the patient may use simple remedies to relieve the discomfort. One person may find that a leisurely walk is the best cure for a headache; another may take aspirin.
　　Certain conditions have been considered classic examples of psychosomatic illness peptic ulcer, eczema, colitis, and asthma. Personality profiles have been developed to describe the typical characteristics of persons who develop such illnesses. Another point of view is that human beings are more complex and varied in their responses than such profiles would indicate, and that the type of illness apatient develops in relation to stress varies with many additional factors, such as heredity and environment. Much remains to be learned about the relationship between stress and physical illness.
　　Physical symptoms, such as palpitation, sweating, or disturbance of sleep, which reflect anxiety, may occur over a prolonged period. The symptoms may seem mysterious and threatening, because the patient is unaware of their cause. The patient whose heart beats more rapidly and forcefully as a manifestation of anxiety may report this symptom to his doctor, believing that something is wrong with his heart. Often the patient is not aware that he is anxious. He knows only that his heart keeps pounding for no apparent reason,
　　Almost any symptom can have its origin in emotional stress. Some patients almost invariably have the same stress when they become anxious. One may have diarrhea, another asthma, and a third may develop hives or eczema. Some people develop two or several different symptoms; often the symptoms are experienced in an alternating fashion.
　　The development of bodily symptoms is only one manifestation of anxiety. It may show up also in symptoms that are primarily mental, such as the inability to concentrate or to remember. Such symptoms, too, vary in degree. Many people occasionally experience symptoms like moodiness or depression. When such symptoms are severe or long-lasting , they interfere with the functioning of the individual in daily life and with his relationships with others.
　　Sometimes a person subconsciously develops an illness as a way of handing a desperate need, such as the need for affection. The only real cure is to satisfy the primary desire. An example is a woman who has pain in her heart, not because of organic heart disease, but because the symptom is a way of gaining, if only temporarily, the love and the attention for which she longs. Her husband cannot leave her when she is so sick; her children are concerned. Her pain is just as severe as if it had a physical cause.

The reality of psychosomatic illness
　　Is the patient with psychosomatic illness really sick, or does he merely imagine he is sick? Many people, including the families of patients and members of the health professions, believer that physical illness which is influenced by emotional stress is less real, or wholly imaginary. Acknowledging the reality of the patients’ illness is important; it is the first step in helping him.
　　Patients with psychosomatic illness are likely to be neglected. The same staff who give excellent care to other patients, not uncommonly ignore them. Some possible reasons may include the use of the term psycho as a prefix. Perhaps this conveys the idea that such patients are mentally ill, and therefore have no physical illness. Perhaps they are considered weaklings. One hears comments like, “He could snap out of it if he wanted to.” Prejudice against these patients may be due to a belief that they are pretending illness in an attempt to get attention or favors.
　　A patient with psychosomatic illness may be confused with a malingerer, oen who deliberately pretends illness in order to achieve some secondary gain, such as financial compensation or excuse from work. Pretending illness is considerd an unhealthy and unsatisfactory solution to the problems of life. Often it adds to the patient’s difficultes, as he makes elaborate attempts to avoid detection. A malingerer can be helped sometimes to find other ways of coping with difficulties. The essential difference between psychosomatic illness and malingering is that the malingerer pretends symptomas. It is a conscious process and he aware that he is pretending to be sick. The patient with psychosomatic illness develops symptoms as a manifestation of largely unconscious psychic conflicts. The symptoms are real.
　　Condemnation of the patient with psychosomatic illness can persist despite intellectual understanding of theories about its causes. The patient can sense immediately whether those who care for him are trying to help him or nor. It is important to understand that:
• The patient with psychosomatic illness is really sick. He is not pretending or imaging his symptoms.
• The idea that he can “snap out of it” at will is no more true than it is of those with disease like pneumonia, whose need for care is readily acknowledged.

Total Words: 990 words
Total Reading Time: _______
The text is based on Introductory Medical ─ Surgical Nursing by Jeanne C. Scherer. Philadelphia: J. B. Lippincott Company, 1977.

Detailed Study of Text A

◆ Reading Skill ─ Inference
Circle the letter of the vest answer.　

1. It can be concluded from the test that a patient with psychosomatic illness _______.
A. needs treatment
B. needs no treatment
C. should consult a psychiatrist instead of a physician
2. From Paragraph 2 we can infer that ________.
A. some people are free from emotional stress.
B. no people constantly demonstrate symptoms of stress
C. different people use different remedies to relieve emotional stress
3. Paragraph 3 suggests that _______.
A. people with peptic ulcer are more often than not to be under stress
B. personality determines the type of illness a patient develops
C. the relationship between stress and physical illness is definitely positive
4. From Paragraph 4 we can conclude that often a patient is _______.
A. neither aware that he is anxious nor aware of the cause
B. unaware of the cause only
C. only unaware that he is anxious
5. From Paragraph 6, we can assume that ________.
A. anxiety shows up in different forms
B. if the symptoms are short-lived, they won’t interfere with a person’s life
C. symptoms that are primarily mental vary in degree, but bodily symptoms don’t
6. A young man who pretends to be mad to avoid drafting may be termed ______.
A. a patient with psychosomatic illness
B. a malingerer
C. a conscientious objector

Key: 1. C 2. C 3. B 4. A 5. B 6. B

Decide whether each of the following statements is true or false.
1. _______ Psychosomatically sick people will stop cheating when they sense that those who care for them are belittling them.
2. _______ The symptoms of people with psychosomatic illness are primarily mental.
3. _______ Moodiness and depression are symptoms that don’t last long.
4. _______ People with psychosomatic illness tend to be given less care than they deserve.
5. _______ Pneumonia is not a disease normally considered psychosomatic.

Key: 1. F 2. T 3. F 4. T 5. T

Vocabulary Building

I. Give the other parts of speech of each given word.

Key:

II. Fill in the blanks with words that are often confused.

1. remedy, recipe
a. I often use herbal ________.
b. What is your ________ for success?
c. A good night’s sleep would be the best _______ for your headaches.
d. He didn’t follow he ______ and the cake came out all wrong.
2. alter, alternate
a. Most farmers ______ their crops on a yearly basis.
b. I didn’t recognize him, he had ________ so much.
c. Rainy days ______ with dry ones.
d. She had to ______her clothes after losing weight.
3. knowledge, acknowledge
a. When the results of the vote were announced the Prime Minister ______ defeat.
b. My _______ of French is rather poor.
c. She is _________ as an expert on the subject.

Key: 1. a. remedy b. recipe c. remedy d. recipe
2. a. alternate b. alter c. alternate d. alter
3. a. acknowledged b. knowledge c. acknowledged

Ⅲ. Glossary

influenza      pneumonia       bronchitis       tuberculosis
asthma        scarlet fever      cholera         diarrhea
syphilis        allergy          insomnia       dyspepsia
migraine       jaundice         ulcer           rabies
leprosy        anemia           hemorrhage     apoplexy
rheumatism    arthritis          rickets          coma

4. Cloze
Fill in each blank with one suitable word.

Acknowledge disease thorough prevent psychosomatic
Welfare confidence points essential upsetting
Symptoms physician emotional due step physical

　　The first _______ in helping the patient is to accept and _______ his illness. The cause of symptoms must be found, and measures to relieve them and to ________ recurrence must be taken. Thorough examinations are ______. Although the ______ may suspect that the illness is _______ to emotional rather than physical causes, he must search carefully for any evidence of ______ disease. It is not unknown for an illness considered ______ to be later diagnosed as cancer or some other _______. The thorough search for physical causes of the symptoms helps to gain the patient’s ______. He knows that his condition and ________ are being taken seriously. If no organic basis for his complaints is found, he usually will find this news easier to accept when he knows he has had a ______ examination.
　　Finding no physical cause for the disorder points the way to understanding the patient’s condition. What is the cause? It is ______ stress? If so, what kind? What are the problems which are ______ the patient？

Key: 1. step 2. acknowledge 3. prevent 4. essential 5. physician　 6. due 7. psychosomatic
8. symptoms 9. diseases 10. confidence 11. welfare 12. thorough 13. emotional 14. upsetting