Why Do People Get Ill? Exploring the Mind-Body Connection Darian Leader and David Corfield Hamish Hamilton, 384pp, £16.99

Darian Leader and David Corfield, in their fascinating new book, tell us that most general practitioners listen to their patients for roughly only three minutes before interrupting them; within ten minutes they will have written them a prescription. Most patients would be disappointed if they left the surgery without one; they are also disappointed if their consultation doesn't involve a physical examination.

It isn't surprising that so-called "holistic" medicine has become a preoccupation of the modern era. It is the patient rather than the illness that has to be treated, the person rather than the organ. As the psychoanalyst Michael Balint pointed out in the 1950s, the "drug" most frequently used in general practice is actually the doctor and his attitude, his "self".

Leader and Corfield stress that "even the simplest psychological perspective on human transactions will show how material objects like pills become signs of many other things, just like the presence and manner of the doctor". Throughout history, the "laying on of hands" has been part of medicine, as have the ceremonies that surround it. Patients have often been considered "possessed" rather than just sick. This is a useful position, and one to which we are returning.

But often, holistic treatment and its partner alternative therapies and cures are merely another form of straight medicine; they just use different drugs. Modern genetics emphasises this view of illness, turning us into victims, if not into machines that have malfunctioned. Increased knowledge of the brain, apparently a hard science at least, translates feeling into numbers. Not that reductionism is new; scientists have always been looking for the "ultimate matter" of the universe.

But as we well know, we are not only brains; we have minds, and the language we use about the brain is quite different from the one we use for the mind. On one side there are "objective facts", on the other Shakespeare. The language of science cannot replace the language of love, or of death, while we remain human rather than robots. So while the impersonality of the physician may be one of his virtues, it may also be a drawback. Leader and Corfield argue that the good doctor has to be a humanist as well as a scientist.

Sigmund Freud taught us, a hundred years ago, that what we call symptoms are not only signs of repression (of that which we would rather forget), but they are forms of expression, too, a kind of personal art. The patient is speaking, to himself or herself, to others, but in code. The symptom - the headache, the refusal of food - is a communication.

Not only that: people are deeply attached to their symptoms. Loving and enjoying them, they both wish to have them removed, and passionately want to keep them. Freud taught us that people have a lot to gain from their illnesses; sickness has its benefits, and not only in getting us a few days away from school or the office. The alternative to the symptom is not good health, but can be depression, emptiness, autism, psychic death.

In its true form, therefore, holistic medicine would see the place and function of the illness in the life of the patient as an integral part of his or her history. All of us may be liable to numerous illnesses and disorders, but when do they occur? Leader and Corfield would prefer to ask not "How long have you had this illness?" but "When did it start?".

Physicians have long noted that illness often appears at significant times: at the anniversary of the death of a loved one, for instance. Using numerous vivid examples, the authors show us that it is only the patient's language - what they say - that will tell us what the illness might represent in someone's life.

Patients are human beings who exist only through the medium of language. As Leader and Corfield write, "Words get into our heads and continue to influence us even years after we have heard them. They mould our very experience of reality." Language determines people's experience of the body. After all, our language is saturated with such terms as "a broken heart", "a pain in the neck" or "he makes me sick". As such, the doctor has access to the patient's deepest self through the patient's words, and through the quality of his or her own listening.

It does not follow that doctors should become psychoanalysts, but there is no reason why they cannot learn to ask better questions.

Psychoanalysis privileges movement - towards the new. It does not require the restoration of a state before the patient was ill. For psychoanalysts the elimination of symptoms is desirable, but it is not the whole story. The whole story is the whole person.

This important, unusual and timely book should be read by everyone working in the medical profession, and by everyone else who has reason to meet them.

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