It is the belief in psychosomatic illness that legitimizes the abuse of patients. Unexplained symptoms are viewed as behavioral and attitude problem rather than as undiagnosed / undiagnosable disease. Psychosomatic diagnoses are a form of dehumanization.
yes it is this combined with the persons inherent cynicisms about life and others.
What is most apparent to me is the ease with which people are inclined to not believe other human beings when they say they are suffering. Those who have or have had struggles in their own life seem all too ready to believe that someone is underserving of sympathy - and if its a psychosomatic illness - that leaves an open goal for them to project their own frustrations into an abusive attitude to the patient. Its a double whammy - because people dont really buy psychosomatic illness as 'real' or deserving - even if they are psychiatrists who claim to.