Arthur Barsky has a thought-provoking chapter entitled “The Validity of Bodily Symptoms in Medical Outpatients” in Arthur Stone’s important Science of Self Report (more available here):
“Although history-taking is the key to diagnosis in clinical medicine, and symptom relief is the goal of medical treatment, symptoms are often unreliable and invalid measures of the extent and [...]
Medicine has developed a pragmatic way to represent the verbal reports of patients within the context of diagnoses: for instance, patients report something about their experience; this is represented as a “symptom” on a “SOAP note” (Cutler, 1997): an acronym for subjective, objective, assessment, and plan. Health professionals duly record what a patient says about [...]
An index of the status of introspection within psychology comes from Medin, Markman, and Ross (2004) in the textbook Cognitive Psychology, which notes (pg.20) that:
“Although introspection is not an infallible window to the mind, psychological research is leading to principles that suggest when verbal reports are likely to accurately reflect thinking“
These perspectives all can be [...]
While the anatomical basis of how nerve projections enable perception of the body is rather well known, physicians confront situations where patient verbal reporting about symptoms does not match models based on neurophysiological mechanisms. For instance, the Merck Manual Medical Library (2009) states:
“Painful stimuli from thoracic organs can produce discomfort described as pressure, gas, burning, [...]
