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Helen Flanders Dunbar: the mother of psychosomatic medicine – psychiatry in history

Published online by Cambridge University Press:  30 January 2023

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Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

Helen Flanders Dunbar (1902–1959), known as the mother of psychosomatic medicine, was a polymath. By the age of 22, she could speak 15 languages and dialects. She obtained four degrees over 7 years, including a doctorate on Danté; then qualified in medicine and psychiatry; studied the healing shrines of Europe; became one of the first to promote the work of clerics in hospitals; and was a founder of the American Psychosomatic Society and the first editor of Psychosomatic Medicine.

In 1929 Dunbar spent a year in Europe to complete her studies, meeting the leading figures in Vienna and Zurich, including Freud, Wagner-Jaurreg, Bleuler and Jung. Freud offered to analyse her, which she turned down. Visiting shrines such as Lourdes convinced her that those who got better were not those beset by hysterical excitement or expecting a miraculous cure, but those who quietly helped themselves and others.

Dunbar, from an Episcopalian family, formed a lasting association with the cleric Anton Boisen to establish training in clinical pastoral care – something now taken for granted – and encourage recognition of the role of spirituality in medicine.

Dunbar believed in combining art and science, manifesting in a holistic attitude. Her 1935 study Emotions and Bodily Changes: A Survey of Literature on Psychosomatic Interrelationships, 1910–1933 (almost 600 pages) provided the theoretical and methodological foundations of psychosomatic research. With Franz Alexander she was regarded as the leading authority in the field. She differed from Alexander's organ-specificity model, instead using the term personality constellation. Not a traditional Freudian, she was more eclectic, preferring the symbolism of Jungian and Reichian typologies.

Her studies also led to the finding of accident proneness which, tragically, could apply to her own life. This was a serendipitous discovery when she used orthopaedic in-patients as a control group against other groups of patients, only to find that a group of the former kept returning with injuries.

Dunbar mixed easily with figures such as Margaret Mead and Eleanor Roosevelt and had a large public profile with her articles on a range of subjects in Time and Readers’ Digest. She was dynamic, charming and attractive, always immaculately dressed. This mostly worked in her career, but also led to a hostile reaction from some in the male-dominated world she operated in. Her views on publicly funded medicine also were not appreciated by a conservative profession.

After the 1930s, Dunbar's life took a downward trajectory. Her ideas on psychosomatic medicine were rejected for a biologically oriented model. She antagonised people, withdrew from academic life, relationship difficulties multiplied and her face was scarred from a motor accident. Sliding into alcoholism, her personal life became chaotic. She focused her practice on the many women patients who adored her.

Drowning in her home swimming pool at 57 was a sad end for an intelligent, inspiring and charismatic figure whose potential was not allowed to be realised.

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