Somatoform Disorder
Somatoform disorder is a term used in psychology to describe a group of mental disorders that involve physical symptoms that cannot be fully explained by a medical condition. These symptoms may include pain, fatigue, gastrointestinal distress, or other bodily complaints.
Individuals with somatoform disorder may become preoccupied with their symptoms, and may excessively seek medical attention or undergo unnecessary medical procedures in an effort to find relief. The symptoms may also cause significant distress or impairment in their social, occupational, or other areas of functioning.
In the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), somatoform disorder is no longer recognized as a separate diagnosis, but rather is included under the broader category of somatic symptom disorder. This change reflects the growing understanding that the mind and body are closely interconnected, and that psychological factors can play a significant role in the development and maintenance of physical symptoms.
Types of somatoform disorder
As mentioned earlier, the current version of the DSM-5 no longer uses the term “somatoform disorder,” but instead, it categorizes such conditions under the broader diagnosis of “somatic symptom disorder.” The somatic symptom disorder category includes the following types:
Somatic symptom disorder: A condition in which a person has one or more physical symptoms that are distressing, disruptive, and/or impair their daily functioning. The symptoms may or may not have a known medical cause.
Illness anxiety disorder: This type of somatic symptom disorder involves preoccupation with the idea of having or acquiring a serious medical illness, despite having little or no physical symptoms or a mild symptom.
Conversion disorder: Conversion disorder involves neurological symptoms that cannot be explained by a medical condition, such as paralysis, blindness, or seizures.
Factitious disorder: A rare disorder in which a person deliberately produces or exaggerates physical symptoms to gain attention or sympathy. This disorder is often referred to as Munchausen syndrome.
Psychological factors affecting other medical conditions: This type of somatic symptom disorder involves psychological factors that impact the course or outcome of a medical condition, such as depression or anxiety affecting recovery from a physical illness.
Symptoms of somatoform disorder
As previously mentioned, the current DSM-5 classification of somatic symptom disorders does not include the term “somatoform disorder.” However, the symptoms of somatic symptom disorders are characterized by the presence of one or more physical symptoms that cause significant distress and/or impairment in daily functioning, and are not fully explained by a medical condition.
The specific symptoms of somatic symptom disorder can vary widely between individuals, but some common signs may include:
Pain or discomfort in one or more areas of the body, such as the head, stomach, or back.
Fatigue, weakness, or lethargy that is not related to physical exertion or illness.
Gastrointestinal problems, such as nausea, diarrhea, or constipation.
Neurological symptoms, such as dizziness, numbness, or tingling sensations.
Reproductive or sexual problems, such as loss of libido or painful menstruation.
Unexplained weight loss or gain.
Hypochondriasis or illness anxiety, which involves excessive worry or fear about having a serious illness.
Excessive or frequent seeking of medical attention, including multiple doctor visits or medical procedures.
Treatment of somatoform disorder
The current DSM-5 diagnosis of somatic symptom disorders involves a biopsychosocial approach to treatment, which means that it addresses both physical and psychological factors that may contribute to the disorder. The goal of treatment is to alleviate symptoms, improve functioning, and enhance the overall quality of life for the individual.
Psychotherapy: One of the primary treatments for somatic symptom disorders is psychotherapy. Cognitive-behavioral therapy (CBT) is a type of therapy that can be particularly helpful in treating somatic symptom disorders. CBT aims to help individuals identify and change negative thought patterns that contribute to the disorder. Additionally, a therapeutic approach called somatic experiencing therapy may be beneficial, which aims to help individuals focus on the physical sensations they are experiencing and learn how to regulate their nervous system response.
Medication: Certain medications, such as antidepressants or anti-anxiety drugs, may be prescribed to help alleviate symptoms of somatic symptom disorders.
Mind-body techniques: Mindfulness meditation, yoga, tai chi, and other mind-body techniques may help individuals learn to manage physical symptoms and improve overall well-being.
Education and support: Education and support can be helpful for individuals with somatic symptom disorders to learn more about their condition and find support from others who are going through similar experiences.
Treatment of underlying medical conditions: In some cases, individuals with somatic symptom disorders may also have underlying medical conditions that need to be treated. If a medical condition is discovered, appropriate treatment can be recommended.
Difference between conversion disorder and OCD
Conversion disorder and obsessive-compulsive disorder (OCD) are two separate conditions that differ in their symptoms and underlying causes.
Conversion disorder is a somatic symptom disorder that involves the presence of neurological symptoms that cannot be explained by a medical condition. These symptoms can include blindness, paralysis, seizures, and other physical symptoms that affect the functioning of the body. The symptoms are believed to result from psychological factors, such as stress, trauma, or emotional conflicts. Conversion disorder is often associated with a loss of sensory or motor function that is not consistent with medical explanations.
On the other hand, OCD is a mental disorder that involves the presence of persistent and intrusive thoughts or obsessions that are accompanied by repetitive behaviors or compulsions. These obsessions can include fears of contamination, doubts about safety, or unwanted taboo thoughts, while the compulsions can include behaviors such as excessive cleaning, checking, or repeating specific actions. OCD is typically associated with significant distress and impairment in daily functioning.
While both conversion disorder and OCD involve psychological factors, they differ in their symptoms and presentation. Conversion disorder is characterized by physical symptoms that cannot be explained by a medical condition, while OCD is characterized by persistent thoughts and repetitive behaviors that are difficult to control. Additionally, the treatments for conversion disorder and OCD differ, with psychotherapy and medications being the primary treatments for OCD, while psychotherapy is the primary treatment for conversion disorder.
Psychoanalytic perspective in conversion disorder
The psychoanalytic perspective suggests that conversion disorder is a result of the unconscious psychological conflicts that are converted into physical symptoms. According to psychoanalytic theory, individuals who experience high levels of anxiety or stress may repress their emotions or thoughts, which can manifest as physical symptoms.
Sigmund Freud, the founder of psychoanalytic theory, proposed that conversion disorder is a form of “hysteria” that results from unconscious conflicts between the id, ego, and superego. Freud suggested that the physical symptoms of conversion disorder are a symbolic expression of repressed emotions or desires that cannot be expressed consciously.
From this perspective, the physical symptoms of conversion disorder serve as a defense mechanism against the anxiety and emotional distress associated with repressed thoughts or emotions. The physical symptoms allow the individual to express their distress in a way that is more acceptable or manageable than verbalizing or processing their emotions consciously.
Psychoanalytic treatment for conversion disorder typically involves the exploration of unconscious conflicts, such as past traumas or repressed emotions, through talk therapy. The goal of psychoanalytic therapy is to help individuals understand and process their unconscious conflicts, which can lead to a reduction in physical symptoms. Additionally, techniques such as hypnosis and free association may be used to access repressed emotions and memories that contribute to conversion disorder.
