Somatoform Disorder, also known as Psychosomatic Disorder and Somatic Symptom Disorder (SSD), is a mental health issue characterised by somatic (body-based) aches and pains as a result of psychological stress and distress.1 Somatoform Disorder affects young people in particular, as they often find it difficult to articulate their psychological states effectively.2 SSD can affect both children and adults.

When it comes to our overall health and well-being, the mind and body are closely linked.3 Psychological issues can present as physical symptoms, and physical health issues can further manifest as psychological difficulties and conditions such as anxiety and depression.4

When a client visits their GP with a series of physical aches and pains that cannot be explained (known as Medically Unexplained Symptoms, or MUS5), it is important to consider how that client’s psychological states may be influencing their physical well-being. Physical issues may manifest as a result of:

  • Anxiety (Generalised, Panic, Social, Phobia)
  • Eating Disorders
  • Depression

To effectively manage somatoform disorder, it is essential to identify and treat the underlying mental health conditions at play. Methods of managing Somatoform disorder include6:

  • One-to-one therapy
  • Family-based therapy
  • Medication
  • Sleep and nutrition advice

Categories of Somatoform Disorder

Somatoform disorder can present in many different ways. These include7:

  • Persistent Somatoform Pain Disorder
  • Dissociative/Conversion Disorder
  • Chronic Fatigue Syndrome

Persistent Somatoform Pain Disorder is characterised by:

  • Severe and distressing pain that is felt consistently over time
  • Cannot be diagnosed as a full, specific psychological or physical illness
  • Co-occurs with emotional distress, conflict, or psychosocial difficulties

Dissociative/Conversion disorder involves:

  • Symptoms of dissociation – loss of memories, reduced awareness of personal identity, loss of control of body movements
  • No diagnosable physical or neurological conditions
  • A clear correlation between physical pain and psychological/emotional distress
  • Potential for psychical/psychological conditions or disorders later (This should be kept in mind so preventative measures can be applied)

Chronic Fatigue Syndrome, also known as Neurasthenia, is typically characterised by:

  • Feelings of fatigue and distress following mental effort
  • Weakness and physical distress after physical effort
  • At least two of the following: muscle aches and pains, headaches, sleep issues, irritability, dizziness, difficulty relaxing, or dyspepsia (digestion problems)
  • Depressive symptoms or issues related to nervous system functioning that do not meet diagnostic criteria for a specific condition or disorder

What causes Somatoform Disorder?

There are various causes of Somatoform Disorder. Common causes include8:

  • Children not being allowed or discouraged from expressing their feelings
  • Exposure in childhood to violence, where fear manifests as physical pain
  • Neglect or lack of attention unless a child has clear physical symptoms (pain may relate to a need to be heard or validated, thus creating a learned behaviour)
  • Childhood or adolescent trauma, where emotional ‘splitting’ is required to feel normal
  • Adult traumatic experience
  • Increased pain sensitivity
  • Inability to effectively process emotions

What are the signs and symptoms of Somatoform Disorder?

Recognising the signs and symptoms of somatoform disorder in yourself or a loved one is important so that you can seek the professional help necessary to manage the condition effectively. Symptoms develop in early childhood, and can include include:

  • Abdominal pain, joint pain, headaches
  • Difficulty with concentration, mood stability, and balance
  • Worry or anxiety over gradually deteriorating health
  • Flu-like symptoms, glandular fever-like symptoms
  • Reduced awareness of physical sensations
  • Disturbed motor-function
  • Symptoms develop following a traumatic event

How is Somatoform Disorder managed?

Individual and family therapies are often used to help clients manage somatoform disorders.9 Individuals can attend therapy and engage in psychological work involving:

  • Tools and techniques for developing motivation
  • Development of self-monitoring and self-assessment techniques
  • Development of coping strategies and problem-solving attitudes
  • Techniques for specific symptom management

Family therapy for somatoform disorder typically involves:

  • Encouraging monitoring and assessment within the family
  • Supporting the affected individual with positivity and relaxation techniques
  • Developing problem-solving skills within the family
  • Shifting focus away from symptoms and towards shared pleasurable activities
  • Education around sleep and nutrition health

The goal of treatment for SSD is to create a healthy supportive collaborative effort between all involved parties, including the individual, their family, and medical and psychological professionals.

Professional Help for Somatoform Disorder at Addcounsel

Somatoform Disorder causes difficult and inhibitive physical symptoms in individuals even when no obvious source of that pain can be recognised. What makes somatoform disorder particularly challenging is that many of those suffering do not know exactly why they are suffering, and are often told that ‘it’s all in your head’ or ‘there’s nothing wrong with you’. Such statements can be destructive and harmful as the individual is fully aware of the pain they are experiencing. Somatoform Disorder is real but unfortunately misunderstood by many. As a result of not being understood, many of those suffering are subject to experiencing feelings of depression, loneliness, and hopelessness, which can further exacerbate the physical symptoms of the disorder.

At Addcounsel, we empathise with those suffering from Somatoform Disorder. We can offer individual and family-based treatment and management to help clients take back some control over their condition and restore a sense of personal autonomy. If you or a loved one are suffering from the signs and symptoms of Somatoform Disorder mentioned above, please don’t hesitate to contact us today.

1 Smith, Jonathan K, and Ralph F Józefowicz. “Diagnosis and treatment of somatoform disorders.” Neurology. Clinical practice vol. 2,2 (2012): 94-102. doi:10.1212/CPJ.0b013e31825a6183

2 Konichezky A, Gothelf D. [Somatoform disorders in children and adolescents]. Harefuah. 2011 Feb;150(2):180-4, 203. Hebrew. PMID: 22164950.

3 Renoir, Thibault et al. “Mind and body: how the health of the body impacts on neuropsychiatry.” Frontiers in pharmacology vol. 4 158. 18 Dec. 2013, doi:10.3389/fphar.2013.00158

4 Goodwin, Guy M. “Depression and associated physical diseases and symptoms.” Dialogues in clinical neuroscience vol. 8,2 (2006): 259-65.

5 Rosendal, Marianne et al. “”Medically unexplained” symptoms and symptom disorders in primary care: prognosis-based recognition and classification.” BMC family practice vol. 18,1 18. 7 Feb. 2017, doi:10.1186/s12875-017-0592-6

6 Smith, Jonathan K, and Ralph F Józefowicz. “Diagnosis and treatment of somatoform disorders.” Neurology. Clinical practice vol. 2,2 (2012): 94-102. doi:10.1212/CPJ.0b013e31825a6183

7 Haller, Heidemarie et al. “Somatoform disorders and medically unexplained symptoms in primary care.” Deutsches Arzteblatt international vol. 112,16 (2015): 279-87. doi:10.3238/arztebl.2015.0279

8 Kallivayalil, Roy Abraham, and Varghese P Punnoose. “Understanding and managing somatoform disorders: Making sense of non-sense.” Indian journal of psychiatry vol. 52,Suppl 1 (2010): S240-5. doi:10.4103/0019-5545.69239

9 Smith, Jonathan K, and Ralph F Józefowicz. “Diagnosis and treatment of somatoform disorders.” Neurology. Clinical practice vol. 2,2 (2012): 94-102. doi:10.1212/CPJ.0b013e31825a6183

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