|Psychosomatic Disorder —a mental disorder that causes somatic symptoms—
Definition of psychosomatic diseases:
Psychosomatic disorder, now more commonly referred to as psychophysiologic illness, is an illness whose symptoms are caused by mental processes of the sufferer rather than immediate physiological causes. If a medical examination can find no physical or organic cause, or if an illness appears to result from emotional conditions such as anger, anxiety, depression or guilt, then it might be classified as psychosomatic.
Psychosomatic or Somatoform disorders are among the most common psychiatric disorders found in general practice.
It is a condition of dysfunction or structural damage in bodily organs through inappropriate activation of the involuntary nervous system and the glands of internal secretion.
Psychosomatic disorder is mainly used to mean a physical disease which is thought to be caused, or made worse, by mental factors. Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety.
The DSM III has dropped the category of Psychosomatic diseases, but according to the DSM II classification it has listed 10 categories of psycho-physiologic disorder:
1. Skin disorders
2. Musculoskeletal disorders
3. Respiratory disorders
4. Cardiovascular disorders
5. Genitourinary disorders
6. Endocrine disorders
7. Disorders of organ of special sense – Chronic conjunctivitis
8. Disorder of other types – Disturbances in the nervous system in which emotional factors play a significant role, such as multiple sclerosis.
Sometimes a physical symptom is a metaphor for the person’s psychologic problem, as when a person with a “broken heart” experiences chest pain. Other times, a physical symptom reflects identification with another person’s pain.
Some people also use the term psychosomatic disorder when mental factors cause physical symptoms , but where there is no physical disease. For example, a chest pain may be caused by stress, and no physical disease is can be found.
Physical symptoms caused by mental factors are discussed further in a another leaflet called ‘Somatization and Somatoform Disorders’.
Increasingly doctors are recognizing the importance of dealing with psychological and social factors in relation to physical disease. As a result, many doctors now try to deal with the whole person. This means taking all these factors into consideration. By doing this, it is important to realize that the doctor is not playing down or ignoring the physical disease. Many people with so-called psychosomatic disorders feel that their doctor does not take them seriously. They feel that the doctor believes that it’s all in the mind. The doctor will always attempt to treat the physical illness with appropriate medical treatment if necessary. But he will also be interested to understand more about the person who has the illness. This will in turn help him and the patient to understand the illness better. Sometimes psychotherapy or talking treatment can help.
Patients are given the opportunity and time to talk about their feelings and emotions. This will help provide them with an insight into themselves and help them understand their illness better.
Sometimes it is helpful to look at the whole lifestyle of the person involved. This may require looking at how the stress is dealt with, teaching techniques for stress management, as well as examining factors such as diet and exercise.
What is a Psychosomatic Disorder?
All illnesses can be considered to be psychosomatic. That is, they inevitably involve the mind’s reaction (psyche) to a physical (soma) illness. However, in some illnesses, psychological factors seem to play a particularly important part. They can influence not only the cause of the illness, but can also worsen the symptoms and affect the course of the disorder. It is these illnesses that are termed psychosomatic disorders. Because psychological factors are important in every illness, there is lack of agreement as to what should be considered as a psychosomatic disorder. Many doctors believe that illnesses such as duodenal ulcers, irritable bowel syndrome, bronchial asthma, eczema, psoriasis, high blood pressure and heart attacks are strongly influenced by psychological factors. Sometimes psychological factors can cause ill health without actually causing a disease. As a result of unhappiness, anxiety or stress due to personal problems, physical symptoms may develop. We are all familiar with the headache that develops as a result of stress. Similarly, other physical symptoms can develop. These include nausea, abdominal pain and chest pain, breathlessness, diarrhoea and giddiness and muscle pains.
The psychosomatic diseases are those which touch at the same time mind and body.
Body and mind are one. So it is natural that diseases interact between body and mind, mind and body. The relation between mind and body depends in fact upon the relation between nervous central system and the rest of the body. Or between emotional, intellectual fields and physical organs. Or yet, between subconscious unconscious mind and the body… There are many ways to approach this link!
In fact, there are different approaches of psychosomatic diseases, because each one may have a different dynamic process. For instance, headache can be caused by different psychosomatic way: aggressiveness against others turned back to self, loss of rhythm activity/rest (weekend headache), excess of concentration.
History: Sigmund Freud famously studied psychosomatic illnesses, which informed his theories of the unconscious mind and repression. Many identifiable illnesses have previously been labelled as ‘hysterical’ or ‘psychosomatic’, for example asthma, allergies, false pregnancy, and migraines. Some illnesses are under debate, including multiple chemical sensitivity, Gulf War syndrome, and chronic fatigue syndrome. Some people suggest that stigmatics suffer a psychosomatic illness based on identifying with the biblical crucified Jesus.
The term “psychosomatic” has developed a negative connotation in modern medicine, being confused with malingering, mental illness or outright fakery. Psychosomatic pain is difficult to differentiate from the above conditions but actual psychosomatic pain is real pain caused by unconscious mind rather than symptoms of illness or injury. Psychosomatic illness can result from problems with relationships, stress or other non-physical causes, often influenced by external factors or individuals.
How does a Psychosomatic Disorder occur ?
Illness can be due to many factors. It can occur as a result of social or environmental factors. It may also happen as a result of genetic or hereditary reasons: a tendency for a certain condition to run in families. Some families also tend to suppress feelings: any emotion then tends to be expressed by physical symptoms. Children can learn this behaviour which may continue to adult life. Some people think that it is our personality that is a major factor in determining which illness we develop. For example, people with what is known as Type A personality tend to be ambitious, impatient, and set themselves high standards. They seem more likely to develop heart attacks. Quiet, introverted individuals, who tend to conceal their feelings and fears and to suppress emotions, may be more likely to develop cancers.
Why does a Psychosomatic Disorder occur ?
Why the illness occurs at a particular time is often a mystery. It could be that a combination of the factors mentioned above triggers off the illness. Should there be untoward stress due to personal problems at home or at work, or a bereavement, then an illness may result. We know for instance that certain life events such as moving house, getting divorced or suffering a bereavement can precipitate physical illnesses. Similarly, an existing illness may worsen as a result of these stresses.
Causes of psychosomatic diseases:
Causes are numerous! Here are main ones. First, genetics, which commands a part of the richness of the links between temporal nervous system and vegetative nervous system, which conditions the effect of stress, of depression onto the body. Some people may never have psychosomatic diseases, even if they are stressed! Besides, stress is not the only cause of those diseases, but the way we manage stress. For example, if we deny a problem, it will go down in unconscious easier than if you look at the problem in front. It very important to get aware of denying problems, that which is, by definition impossible for the subject himself. Help of therapists or external sight needed!
After stress, another cause is depression. Depression may induce symptoms even if the subject doesn’t seem depressed. We call that hidden depression.
Here is a list of psychosomatic disorders. It doesn’t mean that each is exclusively psychosomatic, but inclusively: it may not at all be! Your family physician can diagnose it… And also, it’s sometimes difficult to separate between system nervous, cardiovascular, because, many disorders touch more than one organ!
• Nervous system : headache, twitchings, neurovegetative disorders (which may include a lot of other following disorders)…
• Digestive system: gastric ulcer (with Helicobacter Pylori, hyperacidity… then stress may induce ulcers!), colopathy (constipation or diarrhoea)
• Cancers: In fact we cannot say that the cancer is a psychosomatic disorder, there are genetics pathology, surroundings factors, and psychosomatic factors:
• Rheumatism and osteo-musles disorders: arthritis, lumbago, in which we can encounter for example loss of freedom in environment, that produces the same type of limitation in the body. In a way, the body says: look at me, I can do nothing!
• Cardiovascular system: arterial hypertension, throbbing of heart, infarct… Many process can be seen in those cases. Hta can be the consequence of double bounded situation , of which I spoke higher. The only action body find is to increase tension… before it depresses and looses its energy. Throbbing of heart shows anxiety coming soon. For example, a month before an exam, you can feel anxious in stomach. A day before, it may be in heart. The upper level, the “quicker” anxiety. But besides this, throbbing may show that you deny problem you’re in front of. So you have to look at things as they are! As for infarction: first, you have a certain type of personality who can develop coronaries disease: Intolerance to frustration is the key point! (further details later). And also, your infarction does not appear haphazardly: frustration is not far in the past maybe…
• Immunologic disorders: allergy: asthma… connectivitis. Asthma is a rich psychosomatic manifestation. Summing up: been out-of-breath, symbolically! As for connectivitis, it’s difficult to find understanding ways which would explain this problem. Infections also, wherever they take place: for instance, tonsillitis if often repeated, may come when you have something to say that you cannot dare to say…
• Endocrine diseases: hyperthyroidism (both auto immune and endocrine disorder), diabetes,
• Lungs diseases: cough, dyspnea,
• Nutritive function disorders: anorexia, boulimy…
• Gynecology and Obstetric: dysmenorrhiae,
• Sexology: “ejaculatio ante portas”, impotence, anaphrodisy( loss of pleasure): sex is a high place of somatization.
• Dermatology: psoriasis, eczema…
• Child psychosomatic troubles (Chronic Abdominal Pain, Enuresis, appetite troubles…) in which the relation child -mother is so important!
Somatopsychic consequences of diseases:
We often speak about psychosomatic way, but less of somatopsychic way, which is also important, as it complicates evolution of health troubles.
Prevention of psychosomatic diseases:
Good stress management! (to be followed…) Good communication, at first, between mother and baby, and later child and parents, teachers… and everybody later… Indeed, education is very important! But we should teach stress management to every child.
Second, to see things as they are, which is a vast program! (Further development…)
Treatment of psychosomatic diseases:
Two levels in treatment: global and specific.
On the global side, we must manage the situations that induce somatization, for instance: stress. Good communication, self assurance, help you to prevent accumulation of disorders. When the illness is here, treat it in different ways: drugs can be necessary. Acupuncture can help you too, as it works on the two levels, mind and body, relaxing, harmonizing inner tensions. Plants, in the same way, can relax the mind and improve body working. we can use Homeopathy, too, in these indications. Another techniques: mesotherapy, can be also used.
On the specific side, we have to manage each somatization in its particular dynamics. If you stress in case of auto-aggressiveness, you have to observe the situation which induces this stress, aggressiveness, and “auto”-aggressiveness. Different possibilities are moved up to canalize energy. Instead of being a looser in such a situation, you choose consciously to master the facts, looking them in front. Earlier communication can discharge stress immediately… You have to “dare who you are!”
Psychosomatic means mind (‘psyche’) and body (‘soma’). A psychosomatic disorder is a disease which involves both mind and body. Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety. Your current mental state can affect how bad a physical disease is at any given time.
Which diseases are psychosomatic?
To an extent, most diseases are ‘psychosomatic’ – involving both mind and body.
• There is a mental aspect to every physical disease. How we react to and cope with disease varies greatly from person to person. For example, the rash of psoriasis may not bother some people very much. However, the rash covering the same parts of the body in someone else may make them feel depressed and more ‘ill’.
• There can be physical effects from mental illness. For example, with some mental illnesses you may not eat or take care of yourself very well which can cause physical problems.
However, the term psychosomatic disorder is mainly used to mean… “a physical disease that is thought to be caused, or made worse, by mental factors”.
Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety. For example, psoriasis, eczema, stomach ulcers, high blood pressure, and heart disease. It is thought that the actual physical part of the illness, (the extent of a rash, the level of the blood pressure, etc) can be affected by mental factors. This is difficult to prove. However, many people with these, and other physical diseases, say that their current mental state can affect how bad their physical disease is at any given time.
Some people also use the term psychosomatic disorder when mental factors cause physical symptoms, but where there is no physical disease. For example, a chest pain may be caused by stress, and no physical disease can be found. Physical symptoms that are caused by mental factors are discussed further in another leaflet called ‘Somatization and Somatoform Disorders’.
How can the mind affect physical diseases?
It is well known that the mind can cause physical symptoms. For example, when we are afraid or anxious we may develop: a fast heart rate, palpitations, feeling sick, shaking (tremor), sweating, dry mouth, chest pain, headaches, a ‘knot in the stomach’, and fast breathing. These physical symptoms are due to an ‘overdrive’ of nervous impulses sent from the brain to various parts of the body, and to the release of adrenaline into the bloodstream when we are anxious.
However, the exact way that the mind can cause certain other symptoms is not clear. Also, how the mind can affect actual physical diseases (rashes, blood pressure, etc) is not clear. It may have something to do with nervous impulses going to the body which we do not fully understand. There is also some evidence that the brain may be able to affect certain cells of the immune system, which is involved in various physical diseases.
What are the treatments for psychosomatic disorders?
Each disease has its own treatment options. For physical diseases, physical treatments such as medication or operations are usually the most important. However, healthcare workers will usually try and treat a person as ‘a whole’ and take into account mental and social factors which may be contributing to a disease. Therefore, treatments to ease stress, anxiety, depression, etc, may help if they are thought to be contributing to your physical disease.
Treatment Involved for a Psychosomatic Disorder
Increasingly doctors are recognizing the importance of dealing with psychological and social factors in relation to physical disease. As a result, many doctors now try to deal with the whole person. This means taking all these factors into consideration. By doing this, it is important to realize that the doctor is not playing down or ignoring the physical disease. Many people with so-called psychosomatic disorders feel that their doctor does not take them seriously. They feel that the doctor believes that it’s all in the mind . The doctor will always attempt to treat the physical illness with appropriate medical treatment if necessary. But he will also be interested to understand more about the person who has the illness. This will in turn help him and the patient to understand the illness better. Sometimes psychotherapy or talking treatment can help. Patients are given the opportunity and time to talk about their feelings and emotions. This will help provide them with an insight into themselves and help them understand their illness better. Sometimes it is helpful to look at the whole lifestyle of the person involved. This may require looking at how the stress is dealt with, teaching techniques for stress management, as well as examining factors such as diet and exercise.
During Treatment for a Psychosomatic Disorder
There are no particular side-effects from this sort of treatment.
After Treatment for a Psychosomatic Disorder
The reasons that the illness arose are often complex and not easy to deal with. They can be confusing for the doctor as well as the patient. Time is required to allow understanding if healing is to take place. There is no quick and easy answer. During the course of the psychotherapy, sometimes the patient may feel that he is not being understood. It is important to share these feelings with the therapist or doctor.
If a Psychosomatic Disorder is Left Untreated
This depends on the illness, its degree of severity and the possible causes. Psychosomatic symptoms not amounting to a physical disease may improve by themselves. Many psychosomatic disorders, however, are chronic, and tend to wax and wane.
Effects on Family of a Psychosomatic Disorder
People with psychosomatic disorders need the support and understanding of their family and friends. No special expertise is required. A person who will listen and provide support at times of crisis is all that is required.
Homoeopathy: Excellent for Psychosomatic ailments
The psychosomatic disorders like Migraine, Asthma, Acidity, Peptic ulcer, Allergy, Ulcerative colitis, etc. are successfully treated with homoeopathy. Homoeopathy has long recognised the psychological origin of somatic (body) symptoms. Homoeopathy always examines patient’s mental make-up in all cases and remedies are given acting at the level of mind and body together, thus eradicating the disease. Perhaps no other system of medicine has such a superb approach of tackling the mind-body disorders with definite therapeutic agents. Homoeopathic remedies are capable of influencing the state of mind. They can specifically act to alleviate emotional disturbance such as excessive anxiety, irritability, insecurity, obsessive traits, undue jealousy, suspicion (paranoid) fears, depression, neurosis etc. By relieving the emotions such as above, homeopathic remedies bring about harmonious state of health. Thus homoeopathy demonstrates the possibility of the highest goal of medicine, the therapy for the person rather than for the disease alone. Homoeopathic remedies can cure mental & emotional disturbed states.
About the author:
Dr.Samir Chaukkar has graduated in Homoeopathy from the prestigious C.M.P.Homoeopathic Medical College, Mumbai, India, under the aegis of Bombay University following which he has done his doctorate in Homoeopathic medicine from the British Institute of Homoeopathy, U.K. After Graduation he has been practicing Classical Homoeopathy since last 14 years. His keen interest in Addictions