Andrea Calandrelli, Alessandra Nicolini

The mind-body problem is well suited to the discourse on the disease, particularly the “functional” one. Functional disorders represent a challenge for the biomedical model, as they re-propose the old dilemma of the past: are they diseases of the body, or of the mind? In the absence of clinical evidence and objective findings, how can be explained the physical symptoms reported by the patient? The problem of the distinction between mind and body, and of their mutual relations, has always concerned knowledge about human being. This dichotomy still limits the understanding of the origin and significance of functional disease and, consequently, the realization of an integrated care system. Moving from a re-evaluation of corporeality and from a perspective of synthesis that takes into account the unity of the human being in his dynamic relationship with the environment, the essence of functional disturbance is no longer conceivable in the terms imposed by Western tradition as a mind-body split. We propose to reconfigure it in terms of a body-world split. The alteration of the interoceptive processes, which at the experiential level translates into an alteration of the awareness of the embodied meaning of being in the world, leads to states of “sensitization”. Sensitization is generated and maintained by immune-inflammatory processes. The latter are regulated not only by the presence of viruses, bacteria, and toxins, but are also controlled by emotional states. This implies that at the molecular level there seems to be no distinction between mind and body, since cytokines, the main mediators of the inflammatory response, are sensitive and responsive to the world. These implications offer us a new approach through which to understand the original co-belonging of mind and body. The state of health, or disease, is thus the expression of this ontological unicum.

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