Somatoform Disorders

Somatoform Disorders

IN THE EARLY 1800S, THE MEDICAL field began to consider the various social and psychologic factors that influence illness. The term psychosomatic began to be used to convey the connection between the mind (psyche) and the body (soma) in states of health and illness. Essentially, the mind can cause the body to create physical symptoms or to worsen physical illnesses. Real symptoms can begin, continue, or be worsened as a result of emo-tional factors. Examples include diabetes, hypertension, and colitis, all of which are medical illnesses influenced by stress and emotions. When a person is under a lot of stress or is not coping well with stress, symptoms of these medical illnesses worsen. In addition, stress can cause physical symptoms unrelated to a diagnosed medical illness. After a stressful day at work, many people experience “tension headaches” that can be quite pain-ful. The headaches are a manifestation of stress rather than a symptom of an underlying medical problem.

The term hysteria refers to multiple physical complaints with no organic basis; the complaints are usually described dramatically. The concept of hys-teria probably originated in Egypt and is about 4,000 years old. In the Middle Ages, hysteria was associated with witchcraft, demons, and sorcerers. People with hysteria, usually women, were considered evil or pos-sessed by evil spirits. Paul Briquet and Jean Martin Charcot, both French physicians, identified hysteria as a disorder of the nervous system.

Sigmund Freud, working with Charcot, observed that people with hysteria improved with hypnosis and experi-enced relief from their physical symptoms when they recalled memories and expressed emotions. This develop-ment led Freud to propose that people can convert unex-pressed emotions into physical symptoms (Hollifield, 2005), a process now referred to as somatization.