Mental states influencing physical states wasn’t always interpreted as malingering

Wolff’s migraine personality was also informed by a burgeoning psychodynamic literature that viewed bodies as “systems of psychobiological adaptations.” Using this framework, migraine could be understood to be a protective device that provided a way for the body to withdraw from stressful situations. In fact, migraine was thought to be an especially useful adaptation for overruling an overdetermined, overly ambitious mind. Nevertheless, this psychosomatic framework emphasized the realness of migraine. Should any of his students forget that emotions could have as real of an impact as any somatic, measurable fluid, Wolff would remind them. Scrawled on the bottom of his lecture notes were the words “You are at the beginning of a new era when—Loves Hates Fears are as real as management of lump [sic] in the chest or pus in the pericardium.” Psychosomatic medicine did not, for Wolff, mean “imagined.”

Joanna Kempner in Not Tonight

Whereas psychosomatic now means the doctor is washing their hands of you.

Also HAH we distinguish between mental and physical states.