CLP IN INDONESIA

Sasanto Wibisono Consultant Psychiatrist, Dharmawangsa Hospital, MMC Hospital, and Cancer Dharmais Hospital

CLP was brought to the attention of the Indonesian psychiatry around 1980. The enthusiasm started among a few psychiatrists in the early 1990, but was confronted with much reluctant from other medical specialties. The most basic problem for CLP seems to be the poor comprehension and acceptance by non-psychiatrists. Most medical doctors at that time had never been well exposed to psychological aspects of medical problem in their curriculum of medical education. Before 1970, psychiatrists were more familiar with ‘psychosomatics’ which was part of diagnostic entity. It was the lasting effect of Frans Alexander’s psychoanalytic concept of seven holly diseases. ‘Psychosomatic’ was very appealing during 1960’s among medical doctors, especially internist, despite the fact that among psychiatrists themselves the term ‘psychosomatic’ was starting to become obsolete The DSM II was still using psychosomatic as disease entity in its classification. Around the year 1970, psychosomatic is losing its popularity in Psychiatry because of the fact that most diseases have its psychic components and that there are no such clear cut disease which fully justified the ‘psychosomatic’ as disease entity. As a result, ‘psychosomatic’ in psychiatry has lost its scientific specificity as disease entity and reduced to just ‘a modern approach to medicine’ (just like ‘psycho biology’, ‘bio—psycho—social’, ‘comprehensive approach’, ‘holistic approach’, etc). And it was removed in the DSM III, and replaced by a more appropriate term: the ‘psycho-physiologic disorders’. Despite the facts, ‘psychosomatic disease or condition’ has gain popularity among medical practitioners because of its non-stigmatized term related to mental disease, and it will save some practical opportunity for other specialist to keep the patients in their competency. It becomes an escape entity for those cases where no objective cause could be found. The first attempt to introduce the CLP concept to the other Medical specialties in Jakarta was done in 1990 by organizing a large scale symposia at the University of Indonesia Medical School — inviting almost all the Departments of Medical Specialties — and speakers from some of the Departments. Aside from discussion about psychosomatic concern of medical specialties, an introductory history of CLP concepts was presented. The idea was not readily comprehended by the participants, but at least we have disseminated the. idea The next step was followed by proposing mutual understanding for collaborative activities for the benefit of patients suffering from medica co-morbidity with psychiatric problems — to each individual department of medical specialties. After a few decades, only a few Departments responded positively, some with reservation (Obstetrics & Gynecology, Surgery, Plastic surgery, Child & Adolescence, Oncology, etc.). Even though strategic planning for CLP in modern hospital is a crucial need, this has not become a mandatory requirement for General Hospital in Indonesia. At present, some of the University Hospitals and General Hospitalsin Indonesia have develooed a well-established CLP services.

reference:

8^th National Congress of Indonesian Psychiatric Association

15^th Asean Federation for Psychiatry and Mental Health Congress

25-27 August 2016, Semarang - Indonesia 

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