Towards a Second Social Movement in Biopsychosocial Science and Medicine

The American Society for Research on Psychosomatic Problems began in 1942 as a social movement—a collective effort of clinicians, social workers, and scientists to humanize medicine amid global conflict and uncertainty (1–4). At that time, humanity faced existential threats, including the rise of fascism, expanding atrocities of the Holocaust, widening economic inequality and instability, and the possibility of mass annihilation by nuclear weapons. By then, tens of thousands of people in the United States had been forcibly sterilized because of the pseudoscience, eugenics. Also in the United States, Black Americans endured oppressive discrimination and segregation, and those of Japanese descent and Indigenous Americans were subject to inhumane treatment by state and federal governments. Those who created the American Society for Research on Psychosomatic Problems, soon renamed the American Psychosomatic Society (APS), were unified during that period not only by resistance to an increasingly dehumanized and reductionistic form of medicine, but also by devotion to care for people suffering from conditions arising from poorly understood interactions between mind and body unfolding within a social context (1–5). Among the key events leading to APS were the publication of Helen Flanders Dunbar’s “Emotions and Bodily Changes” and the launch of Psychosomatic Medicine in 1939, for which Flanders Dunbar served as the first Editor-in-Chief. Psychosomatic Medicine was described as a forum “…devoted not to the isolated problems of the diseased mind or the diseased body, but to the interrelationships between emotional life and bodily processes” (4). Led by Flanders Dunbar as its inaugural President, APS, in turn, began as a community for “…those interested in the scientific exploration of these complex relationships” (4). Given these foci, the word chosen for the names of APS and what would later become its flagship Journal was psychosomatic, which comes from the Greek roots psyche (mind) and soma (body). As has been noted (6), however, even the founders of APS and the Journal foresaw concerns about the understandability of psychosomatic to those outside the Society and Journal. Over time, more concerns emerged about its representativeness and inclusiveness. For example, in the 1960 APS presidential address, Wittkower argued: “The future of psychosomatic medicine…lies in a multidisciplinary approach. However, it may be seriously questioned whether the outcome of such a comprehensive multidisciplinary study would still be justifiably and adequately covered by the term psychosomatic” (5). Wittkower judged psychosomatic as insular and as insufficiently representing the emphasis of APS and the Journal on interactions among biology, psychology, and macrosocial and cultural processes in understanding health and illness—an emphasis now separating the Society and Journal from others for over eight decades. Lastly, although psychosomatic medicine is a hub discipline and firmly established in academia, medical training, and health care systems in many countries, the past century has witnessed the spread of other meanings of psychosomatic, particularly where English is the common language (6). Since the founding of APS and its Journal, these concerns and linguistic developments led to several name-change initiatives that considered alternatives to psychosomatic. None led to new names because none resulted in at least two-thirds majority support by members in Society-wide votes held in accordance with Society bylaws. However, one initiative added a subtitle to Psychosomatic Medicine: namely, Journal of Biobehavioral Medicine (6). The most recent name-change initiative began in March 2023—approximately 10 years after the last was conducted by Past President Martica Hall and 3 years after the SARS-CoV-2 virus led to the COVID-19 pandemic. Emerging from 2 years of suspended in-person meetings of the Society and global social isolation resulting from the pandemic, there was uncertainty about the future of scientific meetings and relevance of being a part of research societies. This uncertainty arose in the world context of mass social justice movements catalyzed by the horrific murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and countless other Black Americans; the rise of anti-Asian hate crimes in the wake of the pandemic; and an expanding awareness of social health inequities caused by the climate crisis ((7), see also (8)). At this time, the Society and Journal pivoted toward antiracism, inclusiveness, and equity (9). The major events leading into 2023 defined the context in which a new name-change initiative would emphasize, as Wittkower did, the vital relevance of representativeness, as well as sociocultural and environmental factors in the mechanistic study of mind-body interactions shaping health and disease. The initiative in 2023 would also center on the voices of APS members and Journal leadership over months of surveys, meetings, and community-caucusing. What emerged was unambiguous support for the broad term of reference biopsychosocial, popularized (but not coined) by Past President George Engel (10). What also emerged was a call from members for a name that embodied the Society—especially its community, purpose, internationality, multidisciplinary breadth in science and medicine, and orientation to public impact. It was decided by the Society’s governing Council that Society for Biopsychosocial Science and Medicine (SBSM) met the members’ call. Shortly after the Council’s decision, the Editor-in-Chief of Psychosomatic Medicine, Suzanne Segerstrom, and the editorial leadership proposed changing the Journal to Biopsychosocial Science and Medicine. Anticipating these possible historic changes, a new mission was proposed: “To advance biopsychosocial science and its application for health.” In February 2024, members voted with 90%–95% support for these new names and mission. After ratification, members were informed at the March 2024 Annual Meeting Chaired by Kristi White in Brighton, UK. That members came together with such support for change may one day be described as an inflection point in the shared histories of the Society and Journal. It may also become known as the start of a “second social movement”—most clearly articulated in SBSM’s new guiding principles, introduced in 2024: equity, honesty, transparency, justice, and belonging. Notwithstanding these changes, the DNA of the Society and Journal is still rooted in social consciousness and a desire to understand contextual mind-body interactions. This is evident in how biopsychosocial science can be defined—as an interdisciplinary field that is focused on understanding the interacting biological, psychological, social, behavioral, and environmental processes that contribute to human health and disease across the lifespan. It is also evident in how biopsychosocial medicine can be defined—as applying this scientific understanding in clinical and public health contexts to prevent, manage, and treat disease. Brutalities of war, existential threats, social injustice, and geopolitical conflict all face the world now as they did in 1939 and 1942, yet the Society and Journal remain as poised as ever to impact the public for a greater good. Peter J. Gianaros, PhD Department of Psychology and Center for Mind-Body Science and Health University of Pittsburgh Pittsburgh, Pennsylvania [email protected]Tené T. Lewis, PhD Department of Epidemiology Rollins School of Public Health Emory University Atlanta, GeorgiaSuzanne C. Segerstrom, PhD, MPH School of Human Development and Family Sciences Oregon State University Corvallis, OregonA. Janet Tomiyama, PhD Department of Psychology University of California Los Angeles Los Angeles, CaliforniaTara L. Gruenewald, PhD Department of Psychology Chapman University Orange, California