CHAPTER 19

 

SOMATOFORM DISORDERS

 

 

 

GENERAL PRINCIPLES

Before embarking on treatment, the physician or therapist must understand several straightforward, but often misunderstood, principles of diagnosis. Without this understanding, both treatment goals and doctor-patient communication may become hopelessly confused. It is often therapeutic to discuss the somatoform diagnosis openly with the patient as well (McCahill, 1995).

Psychosomatic symptoms are very real. They may either be physically real (as in the case of some asthma, heart palpitations, or gastrointestinal complaints such as irritable bowel syndrome), or emotionally and behaviorally real but without physiologic signs (e.g., in hysterical blindness or paralysis).

The latter kind ...

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