Psychomaintenance of Chronic Physical Illness

TLDR: The mechanisms of psychomaintenance appear to be general across illness types and often so commonplace as to be overlooked.

Abstract: Psychomaintenance refers to the psychologic and behavioral perpetuation and exacerbation of physical illness (Dirks, 1978; Jones, Kinsman, Dirks, & Dahlem, 1979). In this regard, it should be noted that psychomaintenance does not address the etiology of illness as an area of interest but instead focuses on how psychologic and behavioral factors maintain and increase both perceived severity and medical intractability of the illness once it has already developed. How is it that the patient continues to be functionally incapacitated by illness, despite medical treatment that is effective in most other cases? How is it that the patient appears to require a disproportionately intense medication regimen? How is it that the patient continues to be hospitalized longer and more frequently than would be indicated by the objective medical parameters of the illness? What is the patient doing to contribute adversely to his or her medical response? What is the patient not doing in relation to the illness, and what negative effects does that have on medical management and treatment? These are questions whereby the specific mechanisms of psychomaintenance can be isolated. The mechanisms of psychomaintenance appear to be general across illness types and often so commonplace as to be overlooked.