As "nothing wrong" can be found with us, they just assume that somatization is the only thing that can explain our symptoms, and they will pathologize any sane behavior. We do too much, or too little, we have too much support or too little.
Whatever we do or think, if someone has decided it's pathological, well it will be. Because if we didn't have an abnormal mental health, we wouldn't be sick. That’s circular reasoning. They are so sure of themselves that they can’t even consider a not yet detectable disease. Especially when dealing with women, as we are so prone to mental health and irrationality!
We are supposed to be emotionaly unstable, so when facing a rational patient who does not fit their archetypal distressed somatizing patient, some psychiatrist have other justifications in store, so as to incorporate all the patients.
An example of this psychologization of a normal behavior can be found there.
http://www.google.fr/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCEQFjAA&url=http://global.oup.com/us/companion.websites/fdscontent/uscompanion/us/images/lamberty/lambertypresentation.ppt&ei=PS7PVLPhAcm5UeG_g5gO&usg=AFQjCNE1jO3MwHXTH1jv0S6uosWwmuW9aA&sig2=67_ZxUU-nZtIso5S15Az7A&bvm=bv.85076809,d.d24
p117 and following
Management
All practice settings are different, but I see two fairly distinct presentations where somatizing patients are concerned.
Stoic
- Typically referred by practitioners from various medical specialties like neurology, rheumatology, infectious disease, and cardiology, but also primary care (family practice, internal medicine) clinics, chiropractic practices, and concerned family members.
- These patients appear stoic and matter-of-fact in conveying their concerns, and they emphasize the objective and medical nature of their problems.
- It is often the case that there has been an event (an accident or injury) and the patient is simply not functioning at a level that is characteristic of them.
- While it is not universally true, the stoic patient tends to have had less overall contact with the medical system than the expressive patient.
-rigid and obsessive personality style
-often quite specific about when their difficulties started
-“world was turned upside down” and all difficulties follow that event difficult to sort through the reality of such assertions as the stoic patient will have incorporated the historical truth of their experience in a way that makes it unassailable in their mind
-In neuropsychology practices, the prototypical example of this presentation is the modal mild TBI case
- The dramatic and almost literary quality of “life changing in an instant” seems to be the main emotional hook for the stoic patient. To the extent that any emotion is shown, it is when discussing the event.
“I didn’t ask for this” or “this is not me” are oft-repeated themes that sometimes bring a brief, almost controlled outburst of emotions.
Another example with (Dutch) OoOps Belgian Van Houdenhove
http://psycnet.apa.org/psycinfo/2012-28743-001/ (p 19):
This is often accompanied by so-called hypermentalization or mentalization “on the loose”, and clinicians may be easily led astray by what seem to be elaborate, differentiated, and largely accurate narrative.
Hopefully, Van Houdenhove is there to debunk these particularly hard to detect delusional patients!!
Several features distinguish such accounts from genuinely high levels of mentalizing, including
(a) the excessively lengthy, overly analytical, and repetitive nature of such narratives
(b) the overly cognitive nature of such accounts, out of touch of the underlying affective core of these experiences, or the affectively overwhelming nature of such accounts. […] (my comment: so if you are too emotional, that’s a sign of distress, but if you’re too rational, that’s the sign you’re pathologically dismissing your emotional problems!!)
(c) the inability to “switch perspectives” (my comments: or the inability to adopt the therapist’s view, which can be nothing but the truth, because youa re delusional…)
So we are trapped, they have settled a net that encompasses all behaviors, from “neurotic” to “normal”, so as to catch everyone…
I remember a social psychology study done with psychology students. Unfortunately, I don’t remember where I saw it, if someone’s got a reference, that would be great.
They showed a film displaying a normal person, behaving normally to two students groups. They said to one group, this guy is normal, please describe his behavior. Showed the same film to the other group saying this guy has a psychiatric issue, please find the clues. Guess what happened…
And I don’t think it’s a “psychiatry only” trend. This reasoning can be found throughout the medical system and is endorsed by the whole system. The first ones to adhere to it are the physicians who send us to psychiatrists. And not all psychiatrists agree with this.