Somatisation Disorders

What is meant by somatisation disorders?

This disease is characterised by persistent body discomfort or pain. Despite intensive and precise examinations, no physical cause can be found for these complaints. There are always findings that can explain some of the complaints, but not the full extent. The symptoms can occur only in one region of the body or simultaneously in different regions (head, back, shoulder, arm, chest, abdomen, lower abdomen). Often there is also fatigue or dizziness, gastrointestinal complaints, sweating, restlessness or palpitations. Many sufferers are often told that there is "nothing wrong with them". They feel misunderstood. They become increasingly desperate and hopeless. Even if there are no abnormal findings, laboratory changes and/or abnormalities on the X-ray, there is no doubt that the pain is real and not imagined.

Somatoform disorders are often based on a disturbance in the experience of pain and stress. Affected people are usually more sensitive to stress and pain than other people. Mental factors play an important role in the development and maintenance of the disorder. Mental stress is not perceived mentally. That is why it cannot be expressed. Mental distress then expresses itself in physical form: body pain instead of mental pain. This is not surprising when you know that pain perception and feelings are connected to the same areas in the brain.

How are somatisation disorders diagnosed?

First of all, a careful examination is carried out to exclude an organic cause for the physical symptoms being reported. The diagnosis of somatoform disorder is made through a consultation. The description of the symptoms usually provides enough clues as to the cause of the somatoform disorder. Psychological tests complement the diagnosis. We always use additional test procedures.

Classification of somatoform disorders

The ICD-10 classification system describes the following somatoform disorders:

Somatisation disorder: changing physical symptoms
Undifferentiated somatisation disorder: like somatisation disorder , but incomplete expression
Hypochondriac disorder: anxious brooding about the possibility of suffering from an as yet undiscovered disease
Somatoform autonomic dysfunction: symptom complex that can be assigned to an autonomic organ system
Persistent somatoform pain disorder: chronic pain, the basis of which is assumed to be psychological tension
Chronic pain disorder with somatic and psychological factors: chronic pain with an established physical basis, but whose expression and intensity of experience is shaped by psychological factors
Other somatoform disorders: not linked to autonomic system

How are somatisation disorders treated?

Somatoform disorders can often be treated on an outpatient basis. Hospital treatment may also be necessary, however, due to the severity of the illness. Often, during inpatient treatment, leaving the everyday/overwhelming situation already results in a helpful distancing from tasks and conflicts.

Our treatment concept for somatoform disorders includes therapies that take into account the physical, psychological and spiritual dimensions.

Drug treatment

Painkillers provide no, or at best short-term, pain relief in somatoform disorder and are therefore neither useful nor indicated. Sometimes antidepressants can help to provide some distance from the pain.

With anthroposophic antidepressant medicines, the patient's self-healing powers are stimulated to return to a health-promoting balance. External applications, compresses, rubs and oil dispersion baths support the healing process.

Music therapy

Through music therapy, mental expressiveness is exercised, strengthened and improved. Vibratory capacity and mental mobility increase. Engaging with musical processes is a way and an aid to perceiving and expressing one's own feelings.

Therapeutic painting

We mostly work in the wet-on-wet painting technique and with watercolours, as this technique is very mobile and lively, stimulating the imagination. Thus, through the effect of colour, the mind is stimulated to express its feelings, negative as well as positive, and to bring them into the design. Depending on the individual needs of the patient, other techniques such as shape drawing can also be used.

Therapeutic modelling and sculpture

Modelling and sculpting stimulate the creative strengths. Patients can deal with their feelings in a hands-on way and express them through the clay.

Psychotherapeutic treatment

In psychotherapeutic treatment, the aim is to change the perception of pain. The patient learns to distinguish between pain and feelings. He learns to give a place to the feelings associated with pain instead of suppressing them. Here, schema therapy according to J. Young is an enormously effective and very practical psychotherapeutic method. The consideration of relationships with other people also plays an important role. The aim is to (re)discover one's own needs and desires within the framework of psychotherapy. Another goal is to take these needs seriously and improve self-care. This can enable the person concerned to recognise situations of excessive demands earlier and to find an appropriate way of dealing with them. Often, in the course of therapy (for example, through special emotional methods, such as imagination in schema therapy), events, slights, disappointments and losses, some of which occurred long ago and are still burdensome, can be experienced. They can be put into words, addressed. This provides relief and pain reduction. The pain of the mind can be integrated into one's own life story. In the best-case scenario, the somatoform disorder can thus be resolved.

Prospects: living with the disease

Treatment for somatoform pain disorder is almost not about pain management or learning to "live with the pain". It is about psychotherapeutic treatment of the underlying conflicts or persistent situations of excessive demands. If this succeeds, which certainly requires longer-term continuous outpatient psychotherapy, the body pain will have become superfluous.