Psychosomatic Illness and Somataform Disorder

[SilverbladeTE]

the difference between the cargo cults and psychosomatics is that cargo cult practices were inspired by real occurrences while psychosomatic medicine was based on lies and fantasies.

yeah an important thing to remember in many issues is the difference between LEGENDARY and MYTH

Troy and it's siege, written as one of the first great epics by Homer in "The Iliad" is as we now know, legendary, as it's based on something that really occurred, but of course, people spin stories...how much of the Iliad was factual we can't say.

Myth on the other hand is totally fiction.

 

[alex3619]

i think health is so complicated and be controlled so poorly that one way to deal with that unpleasant reality is to come up with superstitions which give us the illusion of control.

I think we would do much better with truth and honesty rather than control as the primary factor. Few doctors practice that, but some do.

 

[chipmunk1]

Speaking of cargo cults: amusingly, modern psychotherapy does resemble cargo cults in so far they believe that merely acting or thinking like a healthy person will result in a recovery.

Not only this it can also cure cancer...

It has even been observed in cancer patients who received an empty injection but who, nonetheless, had their cancer go into remission, simply because theybelieved they were being injected with a new miracle drug. It seems that the expectations associated with a treatment can often be as powerful as the treatment itself.

https://www.psychologytoday.com/blog/the-empathic-misanthrope/201109/fake-it-til-you-make-it

 

[eafw]

This is the original meaning of the term, the mind affecting the body

I meant that people when discussing it on the boards need to clarify their definition, what it is they are referring to when they say there is no such thing as psychosomatic ?

I realise that the wider world has moved to use it for any old unexplained illness, and that usage has little basis, but the original meaning does have a basis (as in some of the examples I gave) so it would be useful for people to distinguish.

 

[Hutan]

From wikipedia:

Somatization is a tendency to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them.​

From australiandoctor.com.au 2007 (yes, it's old but I have recently come across doctors following these treatment guidelines)
http://www.australiandoctor.com.au/cmspages/getfile.aspx?guid=8f505044-5b14-41e6-bb3d-163e05fb2fa5

'SOMATISATION is common: in one UK study up to 19% of consecutive general practice patients had medically unexplained symptoms (MUS), rising to 45% in another study when only frequent attenders were examined.'​

'GPs are likely to see the following types of somatisation:
■ Somatic presentations of psychiatric disorders.
■ Hypochondriasis.
■ Medically unexplained symptoms.'​

'Probably one of the key hints to a possible diagnosis of somatisation is the GP’s emotional reaction to the patient: a combination of anger and frustration at the complexity of symptoms, the frequency of visits and a sense of helplessness may be a cue that the patient may be somatising.'​

So, if you go see your doctor about some symptoms and they can't find a medical cause, it seems you have a problem of somatisation. If you make the doctor feel angry or frustrated, then that is a very strong sign that you have a problem with somatisation.

I especially like how on page 36 of the link, the GP can earn Continuing Professional Development points by regurgitating these pearls of wisdom in a quiz.

 

[Wildcat]

.
"If you make the doctor feel angry or frustrated, then that is a very strong sign that you have a problem with somatisation"
.
.
If the doctor feels angry or frustrated its more a very strong sign that the doctor is in the wrong job.
.

 

[jimells]

It has even been observed in cancer patients who received an empty injection but who, nonetheless, had their cancer go into remission, simply because they believed they were being injected with a new miracle drug.

What a jaw-dropping statement! I wonder if this magazine considers itself to be "scientific" or "religious".

If this anecdote really happened, wouldn't it be unethical to withhold treatment without consent?

 

[jimells]

It's pretty scary to think the author is a grad student who wants to experiment on people. He thinks the placebo effect is Magic. I understand it to mean, "we don't know what caused the effect".

 

[Sidereal]

'Probably one of the key hints to a possible diagnosis of somatisation is the GP’s emotional reaction to the patient: a combination of anger and frustration at the complexity of symptoms, the frequency of visits and a sense of helplessness may be a cue that the patient may be somatising.'

You'd swear this was from The Onion.

 

[Wildcat]

.

Doctors with anger. frustration, and a sense of helplessness - sounds like the doctor could do with a referral for counselling, CBT and Mindfulness.

Its scary the way med and psyche students buy into that crap about diagnosis by the medic's emotional responses. In any other profession that would be seen as a recipe for disaster based on surreal decision making procedures.

 

[jimells]

'Probably one of the key hints to a possible diagnosis of somatisation is the GP’s emotional reaction to the patient: a combination of anger and frustration at the complexity of symptoms, the frequency of visits and a sense of helplessness may be a cue that the patient may be somatising.'

I swear, the first time I read this, I thought it said the doctor was somatising.

 

[AndyPandy]

 

[antares4141]

I think people should define "psychosomatic". Because are we really trying to say that thoughts/feelings/stress have no effect on our bodies ?

For instance what would you call it when someone is worried about something .. and doesn't want to eat/can't sleep/feels all achey and unwell ? These are real physical effects from anxiety..

Where you get into trouble is when you try to argue other illnesses like gws or cfs are caused by the same types of "stress" We don't know this. It's speculation. For instance you could have made the same argument for limes prior to 1978 when it was discovered. And you would have been 100% wrong.

We don't even know anxiety is "psychosomatic" or caused by stress. It could be an imbalance in our intestinal flora. So it might be possible to alleviate anxiety levels to those which are considered normal. Simply by addressing the imbalances in our flora.

My brain fog/cognitive difficulties are amplified by situations where I am overwhelmed (or stressed). For example if I have to pay my bills or do my tax return, solve a difficult problem, talk to someone I don't want to talk to. All issues I never had before cfs and believe it's the physical process that drives the cfs that causes this not the other way around. Another example would be people with head trauma have psychological consequences. I think from issues with anger and depression, memory cognition. Point I'm trying to make is just because your exhibiting psychological symptoms doesn't mean it's caused by a thinking process or because you lack character or are weak, or have a bad attitude or refuse to "will" it away or have not gotten cognitive behavioral training. Which might help but might not be the underlying problem. Which unfortunately many times is an "expert's" underlying premise.

 

[ahmo]

I've just listened to a radio follow-up to a tv program entitled At Their Mercy. It was about "teaching by humiliation" in medical training. It seems to be the norm, is passed down to subsequent generations. Something like 20% medical students reported feeling suicidal. And not only was it dr/instructors, but also from nursing and other staff, humiliating students and trainees, in front of patients. Which they often then pass it on to us as patients.

I'm pretty sure the tv link is only available in Aus, but the radio is available everywhere.
http://iview.abc.net.au/programs/four-corners/NC1504H017S00

the radio follow-up hasn't yet posted a link to the program which just aired, here's the site. approx 20" segment:
http://www.abc.net.au/radionational/programs/rnafternoons/

 

[Hutan]

I just listened to that radio program too, Ahmo. It made me think of the 'kicking the cat' phenomenon.

From the wonderful Wikipedia:

Kicking the cat is commonly used to describe the behaviour of staff abusing coworkers or subordinates as a mechanism to relieve stress.[5] This behaviour can result in a chain reaction, where a higher-ranking member of the company abuses his or her subordinate, who takes it out on his or her own subordinate, and so on down the line.
According to Psychology Today, "Anger and frustration in one part of life can lead us to lash out at innocent people (or pets) in another."[1] The technical term for this kind of behaviour is "displaced aggression".[1]​

Seems there is quite a bit of anger and frustration going around in the medical profession.
I guess often we are the cat.

 

[ahmo]

@Hutan...Kicking the cat ! Excellent. It was just taken for granted that this is the way it works. At the end of the program the presenter read out a few responses that had come in. Someone in art school, someone in teaching and psychotherapy...same bullying and humiliation there too. The one from arts school was unable to practice art, PTSD lasting a decade after the event.

 

[AndyPandy]

@ahmo and @Hutan I saw that on ABC Four Corners. Horrible behaviour.

 

[adreno]

A somatic symptom disorder, formerly known as a somatoform disorder,[1][2][3] is a mental disorder characterized by physical symptoms that suggest physical illness or injury – symptoms that cannot be explained fully by a general medical condition or by the direct effect of a substance, and are not attributable to another mental disorder (e.g., panic disorder).[4]

In people who have a somatic symptom disorder, medical test results are either normal or do not explain the person's symptoms, and history and physical examination do not indicate the presence of a medical condition that could cause them. Patients with this disorder often become worried about their health because doctors are unable to find a cause for their symptoms. This may cause severe distress. Preoccupation with the symptoms may portray a patient's exaggerated belief in the severity of their ill-health.[5]

Symptoms are sometimes similar to those of other illnesses and may last for several years. Usually, the symptoms begin appearing during adolescence, and patients are diagnosed before the age of 30 years.[6] Symptoms may occur across cultures and gender.[6] Other common symptoms include anxiety and depression.[6] An individual with somatic symptom disorder might experience legitimate physiological changes (e.g., heart rate, blood pressure) presented as interpretations of their symptoms. [7]

A diagnoses of somatic symptom disorder requires that the subject have recurring somatic complaints for at least six months.[

http://en.wikipedia.org/wiki/Somatic_symptom_disorder

No reason to be critical of this. It all sounds perfectly plausible

 

[chipmunk1]

I've just listened to a radio follow-up to a tv program entitled At Their Mercy. It was about "teaching by humiliation" in medical training. It seems to be the norm, is passed down to subsequent generations. Something like 20% medical students reported feeling suicidal. And not only was it dr/instructors, but also from nursing and other staff, humiliating students and trainees, in front of patients. Which they often then pass it on to us as patients.

I'm pretty sure the tv link is only available in Aus, but the radio is available everywhere.
http://iview.abc.net.au/programs/four-corners/NC1504H017S00

the radio follow-up hasn't yet posted a link to the program which just aired, here's the site. approx 20" segment:
http://www.abc.net.au/radionational/programs/rnafternoons/

Yes the system is a complete mess. It's a system of fear of failure and somatisation disorders are needed because they can not admit that they don't know what is going on. Not knowing is seen as a sign of incompetence and weakness in medicine.

The truth is that even the instructors are pretty clueless about a lot of things simply because a lot of the human body isn't well understood yet but as long everything is based on their authority they are of course "infallible" and we are just somatizers.

 

[jimells]

Kicking the cat ! Excellent. It was just taken for granted that this is the way it works. At the end of the program the presenter read out a few responses that had come in. Someone in art school, someone in teaching and psychotherapy...same bullying and humiliation there too. The one from arts school was unable to practice art, PTSD lasting a decade after the event.

Yes, the entire society takes for granted that this is the way the world is supposed to work. We've been handed a fine legacy of organized abuse in the form of rigid authoritarian hierarchies. Practically from the moment of birth we are taught that there is no alternate way to organize ourselves.

I reject that claim.

I learned about the cycle of abuse the hard way, growing up with an alcoholic father and co-dependent mother. I've tried hard not to perpetuate that cycle, which included the decision not to have children. Doctors and nurses who have been damaged by their training can also choose not to perpetuate that dismal cycle. I hope they do so, and soon...