【Creative Cultivation Program】Approaching physical disorders: Let your body express your psychological pain

Do you feel like vomiting when you do your homework? Do you have a stomachache when you start working? Do you feel chest tightness and shortness of breath when you are nervous? Do you have diarrhea when you are angry? Some people have these symptoms, but when they go to the hospital to see a doctor, the doctor says that there is nothing wrong with their organs and that this is a symptom of somatization of anxiety disorder. If you have unexplained physical discomfort for a long time, be careful that it may be caused by somatoform disorder. This article will take you closer to somatic disorders.

What is physical disorder?

Somatic disorder is a group of neuroses characterized by persistent fear or belief in the dominance of various physical symptoms. It is a type of mental disorder with various physical symptoms as its main clinical manifestations. It cannot be proven that there is organic damage or a clear pathophysiological mechanism, but there is evidence that it is closely related to psychological factors or inner conflicts.

The cause of somatoform disorder is still unclear. It may be related to childhood traumatic experiences, sensitive and suspicious personality, genetic inheritance and other factors. The incidence rate is higher in women. Pain is the most common clinical manifestation of patients with somatoform disorder. The pain is multi-sited and not fixed, involving all parts of the body, such as limbs, chest and abdomen, head and neck, etc., which may be unbearable. The physical pain of somatoform disorder is different from the pain you feel when you fall. If you accidentally fall and hurt your knee, your knee will hurt, and the pain will go away when the injury on the knee heals. However, the location of the pain of somatoform disorder is unstable and changeable, and the pain time is also irregular. You may have a stomachache this time and a headache next time. Some people do not feel pain when watching movies for leisure, but they will feel pain when they are doing intensive work; some people do not feel pain when they concentrate on reading or working, but they will feel pain when they are idle.

It is precisely because of the discomfort in the body that patients with somatic symptoms often go to the hospital for medical treatment and help. According to foreign reports, 25% to 50% of patients who visit the hospital have somatic symptoms. Surveys show that the consultation rate, hospitalization rate and hospitalization costs of patients with somatic symptoms are much higher than those of patients without somatic symptoms. After the doctor's diagnosis and treatment, he repeatedly assured that there was no problem with the body's organs, but the patient still felt unbearable pain. The appearance of somatic disorder symptoms is generally related to the patient's neurological function. For example, patients with anxiety disorders are often accompanied by autonomic dysfunction, decreased vagal tension, sympathetic hyperfunction, and imbalanced coordination, thus showing increased muscle tension, somatic symptoms of circulatory, respiratory, digestive and other systemic dysfunctions, which have different degrees of impact on the patients themselves.

2. What are the symptoms of physical disorders?

Patients with somatoform disorders present with multiple, recurring, and frequently changing physical symptoms that may involve any part or organ of the body. Various medical examinations cannot confirm any organic lesions sufficient to explain their physical symptoms. The most common symptoms are:

Gastrointestinal paresthesia, pain, hiccups, acid reflux, nausea, vomiting, etc., skin paresthesia, burning sensation, pain, itching, numbness, tingling sensation, etc., skin spots, sexual and menstrual symptoms. Symptoms often lead to repeated medical treatment and obvious social dysfunction, often accompanied by obvious anxiety and depression.

Currently, there is evidence that this disease is a mental disorder closely related to psychological factors or inner conflicts. The most common symptoms of somatization disorder can be summarized into the following four categories: (1) Pain: This is a frequent symptom. For example, pain may occur in the head, neck, abdomen, back, joints, limbs, chest, rectum, etc. It is not a fixed place of pain, but may occur during menstruation, sexual intercourse or urination. (2) Gastrointestinal symptoms: such as belching, acid reflux, nausea, vomiting, abdominal pain, bloating, diarrhea or certain foods causing special discomfort. Gastrointestinal examinations sometimes only show superficial gastritis or irritable bowel syndrome, which is inconsistent with the patient's severe physical symptoms and is difficult to explain the patient's frequent severe symptoms. (3) Urogenital system symptoms: such as urinary retention, urine retention, or frequent urination, discomfort in the genitals or around them, sexual dysfunction, sexual indifference, erectile and ejaculation disorders, menstrual disorders, excessive menstrual bleeding, abnormal or large amounts of vaginal discharge, etc. (4) Pseudo-neurological symptoms: Common symptoms include: ataxia, limb paralysis or weakness, dysphagia or pharyngeal obstruction, aphonia, urinary retention, loss of touch or pain sensation, diplopia, blindness, deafness, convulsions, ataxia, limb paralysis or weakness, dysphagia or pharyngeal obstruction, aphonia, loss of touch or pain sensation, diplopia, blindness, deafness, including abnormal skin sensations such as itching, burning, tingling and other conversion symptoms. However, neurological examination cannot find corresponding evidence of organic damage to the nervous system or positive signs. (5) Respiratory and circulatory system symptoms such as shortness of breath and chest pain.

3. Physical disorders and psychological stress

1. The correlation between the two

Psychological stress is also a cause of physical disorders. If you feel unwell and go to the hospital for a checkup but everything is normal, you should pay attention to whether you have a somatoform disorder. This is mainly caused by psychological factors, such as psychological trauma, stress leading to anxiety, excessive suspicion or emotional loss, etc.

Because the symptoms are usually related to unpleasant life events or inner conflicts. Psychological pain will manifest itself physically. Some people's depression is more manifested in emotions. This type of depressed patient has better expression ability and can express themselves with accurate words and sentences. Patients who show physical symptoms are not able to express themselves fluently. They can't say it, or they keep it in their hearts because they can't tell others about it. The psychological pressure is too great, which causes depression and pain.

However, such patients usually refuse to discuss psychological reasons. In clinical practice, it is found that many patients with somatization symptoms have alexithymia in real life, that is, it is difficult to express their negative emotions to others in a specific and clear way in a verbal way. Patients feel a strong sense of shame in expressing negative emotions to others. When encountering unpleasant things in real life, they habitually suppress, avoid, and isolate their emotions. However, when the psychological level cannot be expressed in words, negative emotions may be expressed at the physical level, resulting in physical discomfort.

What psychological factors are likely to lead to somatoform disorders?

(1) Psychological trauma

Psychological trauma is indeed very harmful to the human body, unlike physical trauma, which can be healed slowly over time. People who suffered psychological trauma in childhood (such as being abused and insulted in childhood) are more likely to suffer from somatoform disorders.

(2) High psychological pressure

Nowadays, with a fast pace of life and high pressure, people can easily turn mental anxiety into physical discomfort, insisting that there is something wrong with their bodies and repeatedly going to the hospital for checkups. Depression and anxiety occur frequently, and emotions affect physical health.

(3) Lack of daily emotions

If they lack contact with the outside world for a long time or do not get emotional comfort, they will suffer from emotional deficiency. Such people are more likely to suffer from physical disorders. They think these symptoms are physical problems and refuse psychological treatment, which makes the symptoms worse.

4. How to improve symptoms of physical disorders?

General treatment method: The doctor communicates with the patient, informs the patient that he has a disease, and describes the various manifestations of somatization disorder to the patient in a positive tone. The doctor should assure the patient that there is no evidence to prove that physical illness causes the patient's discomfort, and the patient's discomfort may be related to stress. Treat the patient's pain and complaints with patience, sympathy, and acceptance, so that the patient can be understood and find a way to express his inner pain. 2. Psychological treatment method: Psychotherapy is the main form of treatment, and its purpose is to alleviate the patient's psychological factors, change his wrong ideas, face his emotions, and improve his emotions.

(1) Supportive psychotherapy.

Let patients understand the knowledge related to the symptoms of the disease, give them explanations and guidance, and pay attention to psychological counseling for them, so that they can enhance their confidence in treatment. (2) Psychodynamic psychotherapy

Help patients explore and understand the inner psychological conflicts behind their symptoms. (3) Cognitive therapy

For patients with obvious hypochondriasis and hypochondriasis personality, cognitive correction treatment should be given, with emphasis on long-term efficacy. (4) Morita therapy

Making patients understand that the symptoms are not serious in nature and adopting an attitude of acceptance and tolerance of the symptoms is extremely effective in alleviating disease symptoms and improving quality of life.

3. Drug treatment Anxiety and depression symptoms are often accompanied by "somatization" symptoms in patients with somatization disorder. Small doses of anti-anxiety drugs can partially improve the symptoms of patients with somatization disorder. Small doses of antidepressants such as selective serotonin reuptake inhibitors can be used to improve patients' negative emotions and alleviate symptoms.

Physical disorders are closely related to psychological factors. Don't let physical pain express your psychological pain! So let's keep our mood happy, give our body and mind a break regularly, contact friends more often, go out and see the world more often, and relieve stress.

To live a healthy life, you should listen more to your own inner thoughts!

References:

[1]Carl, JR, Miller, CB, Henry, AL, Davis, ML, Stott, R., Smits, J., Emsley, R., Gu, J., Shin, O., Otto, MW, Craske, MG, Saunders, K., Goodwin, GM, & Espie, CA (2020). Efficacy of digital cognitive behavioral therapy for moderate-to-severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and anxiety, 37(12), 1168–1178.

Ma Wenying, Meng Tao, Jia Lihui. Psychological care for anxiety disorder with somatic symptoms as the main complaint[J]. Shaanxi Medical Journal, 2000, 29(5): 297-298. DOI: 10.3969/j.issn.1000-7377.2000.05.021.

[3]https://baike.baidu.com/item/%E8%BA%AF%E4%BD%93%E5%8C%96%E9%9A%9C%E7%A2%8D/1793446

[4]Havinga, PJ, Maciejewski, DF, Hartman, CA, Hillegers, M., Schoevers, RA, & Penninx, B. (2021). Prevention programs for children of parents with a mood/anxiety disorder: Systematic review of existing programs and meta-analysis of their efficacy. The British journal of clinical psychology, 60(2), 212–251.