ABSTRACT
This chapter introduces the psychogenic theory and its presuppositions and presents its distinction from psychosomatic illness. Psychogenic theory presupposes that symptoms, and psychophysiologic responses are associated only with perception or belief of exposure and appraised harmful effects. The chapter also introduces a question about what motivates environmental illness (EI) patients to acquire the sick role. The essential difference between psychosomatic disorders and EI is the absence of an identified defective toxicogenic mechanism, be it immunologic, neurologic, hematologic, or electrical polarity. Neurasthenia was attributed to effects from the industrial revolution, analogous to EI being attributed to environmental exposures. For EI patients with a history of premorbid trauma, EI beliefs and associated ritualistic behaviors serve as defenses to inhibit trauma memories which, if brought into conscious awareness, would create extreme anxiety or overload coping resources. EI patients have been found to report grotesque memories of early childhood physical and sexual abuse experiences.
