Psychosomatic disorders are conditions that can create an imbalance in a person’s life and affect his well-being. Various types of diseases accompany a person throughout his life. Some of them are related to action external factors that have a negative impact on the body. Others are a consequence of the presence of any internal pathologies that provoke a painful condition. However, there is another type of ailment that is not associated with such factors and occurs seemingly for no apparent reason.
Psychosomatic diseases are a special category of ailments that form and develop as a result of the interaction of certain psychological and physiological factors. In most cases, under the influence of various factors that influence the psyche, a somatic disorder is formed that can cause the development of a real disease.
Such a development of events is diagnosed quite often, but there are cases when a diametrically opposite picture is observed, and a minor physical illness, supported by psychological factors, takes on new contours and intensity. In general, such disorders are some kind of mental disorder and have absolutely no real problem behind them. As a rule, the first examination confirms the presence of a fictitious illness that does not require treatment.
The formation of similar disorders can occur under the influence of many factors that leave their mark on a person’s personal qualities. Under the influence of experienced stress, the brain projects its consequences onto its own behavior, building a kind of barrier. This is exactly how similar disorders develop, which have absolutely no real cause other than psychological problems.
Education factors
Psychosomatic disorders can have many reasons for their formation: from stress experienced in childhood to banal problems at work. In most cases, it is social factors that become determining and lead to certain psychological problems, which are expressed in the form of somatic reactions. At the same time, their goal is to avoid the consequences of a previously experienced negative incident. In general, most often such diseases are a response to the following factors and conditions that determine a person’s personal qualities:
- heredity;
- mental characteristics;
- parental influence;
- systematic state of stress;
- overwork;
- various anxieties and experiences;
- the influence of bad habits.
The above reasons may be the main factor in the formation of psychosomatic personality disorders. Moreover, their combination significantly complicates the course of the fictitious disease, making its form more severe and its manifestations more intense.
Reasons
The reasons for the development of psychosomatic disorders can be varied and multifaceted. However, in world medical practice there is a certain classification of factors that contribute to the occurrence of such problems. They differ depending on the motives for the formation of the disease and lie in the psychological state of the person. They look like this:
- benefit and motivation;
- personality conflict;
- experienced negative experience;
- extraneous suggestion;
- self-hypnosis;
- identification with another person;
- self-flagellation.
All these factors in in the best possible way describe the structure of the problem and classify the reasons for its development. Thus, in order to achieve a certain social advantage or momentary superiority, the body is pierced by an attack of pain associated with a non-existent illness. A conflict between facets of one personality that are in constant opposition, or an extraneous suggestion about the presence of an unreal disease can also play a role and be a positive factor for the emergence of a psychosomatic disorder.
Psychosomatic diseases in children
Such problems develop not only in adults, but also in children. As a rule, the causes of these disorders are quite extensive. Sometimes even the smallest little thing can become the starting point in the formation of a problem. A similar state of affairs is associated with the imperfection of the child’s body and its increased susceptibility to various factors that influence it. In most cases, problems in the family are reflected in the development of a psychosomatic disorder in the child, who most acutely absorbs them and projects them onto his own personality. The most common causes of such problems affecting the psychology of children are the following factors:
- unhealthy atmosphere in the family;
- problems communicating with peers;
- anxiety for one's own health;
- fear of being alone.
It is these experiences that have the greatest impact on the child. At the same time, there are still a huge number of reasons why a similar disorder can develop. As a rule, they are associated with the individual characteristics of the body. little man and his sensitivity to the surrounding world, which is especially acute.
Varieties
Today, there is a certain classification that allows us to most accurately understand the main cause of the formation of psychosomatic disorders and provide their optimal treatment.
All the variety of factors leading to the development of such problems fit into three main criteria that describe them. They look like this:
- conversion;
- functional;
- psychomatosis.
Conversion symptoms represent painful sensations, not supported by physical factors. Moreover, their formation occurs at a purely subconscious level in response to the action of oppressive factors. As a rule, the pain does not have a clear localization and can periodically occur in different places. Most often it appears in the limbs or chest area, but over time it gradually goes away, changing its location.
Functional signs are expressed in disruption of the functioning of any organs or systems of the body. They arise against the background of a secondary somatic reaction formed by the action of psychological factors. Moreover, such manifestations have a clear localization, affecting a specific organ or system. However, upon examination of this area, the diagnosis is not confirmed, which to some extent calms the person, and the disease recedes on its own.
Psychomatoses
Psychomatoses form the largest group, formed from quite specific conditions that are a consequence of conflict experiences. They are based on a bodily reaction, supported by psychological problems, which is expressed in pathological disorders and changes in organs. Today, psychosomatic disorders of this type most often imitate and contribute to the real development of the following diseases:
- diabetes mellitus 2 types;
- bronchial asthma;
- obesity;
- ulcerative colitis;
- arterial hypertension;
- neurodermatitis;
- arthritis;
- ulcerative lesions of the stomach;
- thyrotoxicosis;
- coronary heart disease.
Moreover, in the initial stages of development of the disorder there is no real disease, but only its manifestations that have a psychological background. However, with further progression of the problem and inaction on the part of the person, psychomatosis can cause the emergence of a real disease that can cause serious harm to human health.
Symptoms
Symptoms of psychosomatic illness may vary depending on the underlying illness being simulated. However, in some they are mild, which implies the initial stages of the disorder. In other cases, their intensity increases sharply, which is a reflection of more serious stages of development of a person’s psychological instability. The main manifestation of any such illness is the presence of pain that accompanies each type of disorder. They are its most striking sign, provoking a worsening of the situation and the appearance of new symptoms that develop against the background of the initial manifestation. In general, psychosomatic problems are characterized by the following symptoms:
- pain;
- increased heart rate;
- heaviness in the arms and legs;
- chills;
- nausea;
- dyspnea;
- indigestion;
- weakness;
- fatigue;
- dizziness;
- numbness of the limbs.
Each of these symptoms and their manifestations characterize the presence of certain mental problems, inherent in man. At the same time, additional manifestations inherent in one or another fictitious illness that a person suffers from at a given time may be added to such signs.
Treatment Basics
Treatment of psychosomatic disorders is based on the use of an integrated approach. It is not based on the action of any medications or techniques, but on psychological assistance, which is necessary in such a situation. When testing is carried out, the initial diagnosis is not confirmed, and the patient is not prescribed a traditional set of medications and prescriptions for procedures, but is referred to a psychologist. It is psychotherapy for psychosomatic disorders that is the basis for the treatment of such problems. In turn, the work of a psychologist is aimed at making a person aware of the existing problem that served as the impetus for the formation of negative manifestations. As a rule, it is this part of the treatment that is the most labor-intensive and long-term, since it requires enormous efforts from the patient and a detailed analysis of his behavior, as well as personality characteristics.
In some cases, it is possible to use additional motivational measures designed to show a person his capabilities, which he had not previously suspected, hiding behind non-existent diseases. Such means include various sporting events and entertainment programs in which a person directly participates. Only full awareness of the problem and its acceptance is the starting point for the beginning of the healing process, which will inevitably occur in the future and will enable a person to fully enjoy life.
Conclusion on the topic
Psychosomatic disorders and their formation are the result of any problems that have left their mark on a person’s personality. At the same time, there are some factors that provoke the development of such diseases, which lie in the characteristics of a person’s character and the combination of external factors affecting his psyche. The structure of the manifestations of such diseases directly depends on the ailment that the human brain projects, and their intensity depends on the degree of his psychological problems. Based on this, therapy for psychosomatic disorders is based on the use of complex effects, the basis of which is the work of a psychologist.
Mechanisms of formation of psychological problems and psychosomatic disorders:
The material with which bodily psychocorrection works is closely related to psychosomatic diseases. Psychosomatic disorders are nothing more than intense bodily manifestations of psychological problems (usually long-term). Accordingly, the specificity of these disorders is only partly determined by a specific diagnosis (nosological affiliation). To no lesser extent, it depends on the nature of the psychological problem itself, and on the personal characteristics of the bearer of this very problem. Therefore, the physical manifestations of psychosomatic disorders, as a rule, are not confined to the narrow framework of a separate diagnosis - we can only talk about the leading manifestations corresponding to a specific disease. At the same time, as a rule, other psychosomatic symptoms characteristic of other diagnostic units are also present, although less pronounced. Therefore, it is advisable to consider various psychosomatic symptoms not within the framework of individual diseases (nosocentric approach), but individual somatic manifestations (symptom-centric approach).
Speaking about the symptoms of psychosomatic disorders, first of all it is necessary to list the bodily symptoms, which are the result of a tension reaction at the physiological level, and anxiety and frustration at the psychological level. At the same time, psychosomatic disorders of the internal organs are non-adaptive manifestations of stress readiness (V. Ikskul), pain is associated with muscle tension in combination with an increase in pain sensitivity (hyperesthesia). Some psychosomatic complaints have another mechanism of origin - regression, combining both physiological and psychological factors. Physiologically this is a return nervous system into a “childhood” state, psychologically - reproduction on an unconscious level of early childhood experience.
Manifestations of psychosomatic disorders, which have partly a figurative and symbolic meaning (“body language”), are also a manifestation of protective and compensatory mechanisms, a way of resisting subconscious fragments of the psyche against suppression by conscious censorship. Thus, such conversion and dissociative mechanisms of psychosomatic disorders reflect the internal duality and inconsistency of the human psyche. In clinical psychology, there is even a point of view that any chronic somatic (non-infectious) disease begins with an episode of personal dissociation, at least short-term (Schultz L., 2002).
The most typical somatic manifestations of prolonged stress and accumulated unreacted negative emotions are:
A) pain in the heart area that occurs unrelated to physical activity and mimics angina pectoris. It is no coincidence that such functional cardialgia, pain in the region of the heart of a psychogenic nature are described by the intuitively figurative expression “take it to heart.”
B) Pain in the neck and head, especially in the occipital region or migraine pain, covering half of the head; less often - pain in the temporal region or in the face, simulating trigeminal neuralgia.
Pain in the temporal region is often associated with chronic tension of the muscles that compress the jaw: in moments of unpleasant experiences, a person automatically, without noticing it, clenches his teeth (such a “stressful” habit can lead to an unpleasant condition called “temporomandibular joint syndrome”). “Tension headaches” often manifest themselves as a sensation of a tight “helmet” being placed on the head and painfully squeezing it (in medical language there is even a figurative expression “neurasthenic helmet”). Tension of the muscles of the neck and back of the head not only leads to pain in this area, but can also be accompanied by dizziness and other very unpleasant symptoms. Often the appearance of pain and heaviness in the cervical-occipital region coincides with an increase in blood pressure (see below). These problems also have a regression component (muscle tension in the back of the neck first occurs in a young child who is learning to hold his head up).
C) Pain in the abdomen, simulating diseases of the digestive system.
Pain in the epigastric region mimics a gastric ulcer. Occurring initially in connection with an influx of negative emotions, it can gradually develop into actual gastritis or peptic ulcer disease - the distance to a “neurogenic” organic disease is quite close here (especially if a person suffers from low self-esteem, engages in “self-ceasing” both figuratively and literally sense).
Girdle pain, radiating to the lower back, often imitates pancreatitis (unlike a true somatic disease, objective deviations according to laboratory tests are insignificant). At the same time, the person does not seem to “digest” some life situation.
Pain in the right hypochondrium associated with the condition of the bile ducts imitates cholecystitis, and in the absence of objective data, disturbances in the outflow of bile (data ultrasound examination abdominal organs and blood bilirubin level) are specially called “biliary dyskinesia”. The connection of these pains with an emotional state (depression, tendency to depression, irritability or hidden aggressiveness) has been known since the time of Hippocrates and was called “melancholy” (literally translated - “black bile”, which reflects the actual fact of a change in the color of bile, its “thickening” - increasing the concentration of bile pigments in case of stagnation in the biliary tract). The regulation of biliary tract motility is associated with the production of a substance with a local hormone-like effect - cholecystokinin, the disruption of the formation of which is one of the possible physiological components of fear attacks ().
Pain in the middle and lower third of the abdomen can occur both at a moment of acute stress and as an intuitive signal of external trouble, as a physical manifestation of a depressive forecast for the development of events (the figurative expression “feeling danger in your gut”). They are associated with an increase in the contractile activity of the smooth muscles of the intestinal wall - tonic (spasmodic intestinal condition, constipation) or dynamic (increased intestinal motility). In the latter case, the pain is often of a wandering or grasping nature and may be accompanied by a bowel disorder, popularly called “bear disease” and diagnosed as “irritable bowel syndrome.” (The regression mechanism is early childhood experience associated with learning personal hygiene).
It is necessary to take into account that the autonomic nerve plexuses of the digestive tract (located in the intestinal wall) intensively synthesize neurotransmitters. First of all, these are biogenic amines (dopamine, serotonin), a decrease in the content of which in the body is noted in depression. And as you know, decreased appetite and inhibition of intestinal motor activity are typical physical manifestations of depression. Fasting and dietary measures can partly influence this condition towards normalization. Thus, “body cleansing” and “therapeutic fasting” (as well as religious fasts), beloved by the Russian population, are in many ways intuitive ways of self-help for depressive conditions.
D) Pain in the back (in the lower back, in the interscapular region), either regarded as a manifestation of spinal osteochondrosis, or provoking actual exacerbations of this literally painful process. Often, an increase in the tone of the paravertebral muscles is combined with “stagnant” tension in the muscles of the limbs, leading to remote, so-called muscular-tonic manifestations of spinal osteochondrosis.
E) Jumps in blood pressure (usually an increase, less often a decrease), mainly manifested in fluctuations in systolic pressure (and changes in pulse pressure amplitude).
E) Palpitations or heart interruptions, forcing a person to painfully, with anxious anticipation, listen to his heart rhythm.
G) Difficulty swallowing and a feeling of a “lump” in the throat. This may also include a spasm of the muscles that control the vocal cords, which leads to a violation of voice formation (“voice intercepted”). This is how a person often loses his voice in moments of intense emotional excitement. Two regression mechanisms for such disorders can be mentioned: firstly, it is a suppressed cry in infant(“primary cry”, according to A. Yanov); secondly, suppressed speech at an older age (against the background of strict shouts from parents who forbid the child to verbally express his opinion and his emotions).
H) Shortness of breath, not associated with respiratory diseases and manifested as a feeling of “dissatisfaction” with inhalation, accompanied by a desire to take a deeper breath. (The latter can lead to excessively deep breathing - the so-called hyperventilation syndrome). There are also at least two regression mechanisms here. The earliest of them is the first breath imprinted in memory at a subconscious level, which, through the imprinting mechanism, becomes a stereotypical reaction to stress. The second regression component of hyperventilation is the child’s suppressed crying reaction (the child reflexively tries to stop crying by taking frequent deep breaths with short exhalations).
I) In this case, a feeling of numbness and tingling in the hands often occurs (both as a component of hyperventilation syndrome and as an independent manifestation). Similar sensations in the legs may be accompanied by painful cramps in the calf muscles. (The caused long-term stress and a shift in hormonal balance, disruption of the metabolism of microelements, primarily calcium, leading to increased neuromuscular excitability. “Washing out” of calcium from the body in women over 40 years of age can lead to osteoporosis and be accompanied by bone pain.)
J) Nasal congestion, which makes nasal breathing difficult and is regarded as “vasomotor rhinitis.” In contrast to “pure” rhinitis, the deterioration of the condition is usually clearly associated with an exacerbation of psychological problems (conflicts, overload at work, overwork in students, etc.) In this case, painful tension in the muscles of the back of the neck is often also detected (a bodily reflection of the inability to bear the burden responsibility). The regression mechanism is also delayed crying (“unshed tears”).
K) Short-term visual impairment (objects seem to blur before the eyes, and a person has to strain his vision in order to focus it and see the surroundings more clearly). The regression mechanism is the “defocused” vision of a newborn child (transition from a water environment to an air environment, inability to fix the gaze).
Stress-related tension can also lead to more serious visual problems, ranging from visual fatigue, accommodation spasm, which can eventually lead to myopia, or increased intraocular pressure (leading to glaucoma). Symbolic, conversion mechanism of stress-related visual impairment - “I don’t see because I don’t want to see.”
M) The former is often accompanied by dizziness (“when I think about problems, my head starts spinning”), and the latter, in turn, can also be associated with uncertainty when walking, a feeling of “wobbly” legs or a feeling that “the earth is floating under your feet” . The regression mechanism is the sensations of a child who is still learning to stand and walk. Dizziness may be accompanied by attacks of nausea, tinnitus, which reduces hearing acuity - the so-called Meniere-like syndrome (labyrinthine edema). The conversion-symbolic subconscious mechanism of such violations is “I don’t hear because I don’t want to hear.”
H) Flashes of heat (“blood rushed to the head”) or chills (“everything inside froze from fear”), sometimes replacing each other in waves (“throws me hot and cold”), which may be accompanied by muscle tremors (the patient describes my feelings like “I’m literally worried to the point of trembling in my arms and legs”). The regression mechanism is an imperfection of the thermoregulation mechanism in a newborn child who physically needs the warmth of the mother’s body.
A) Loss of appetite - from complete aversion to food to attacks of “ravenous” hunger. (Usually the patient says that in order to calm down in an emotional situation, he needs to “eat his stress”). There are both a physiological mechanism associated with depressive disorders (described above) and a psychological, regression mechanism itself - an analogy with breastfeeding, when a child in a state of discomfort either refuses the breast, or, conversely, seeks the mother’s breast and calms down. For an infant, feeding is not only the satisfaction of the physiological need for food, but also the most important way of receiving positive emotions, and a channel of close bodily communication with the mother (bonding, autonomic resonance).
P) Attacks of psychogenic nausea (less commonly, vomiting), occurring directly in a stressful situation or on the eve (“in anticipation”) of emotionally intense events, unwanted meetings associated with hostile relationships (“he makes me sick”). It is more common in children and adolescents - for example, a child who does not want to go to class, where he is subjected to pressure (or humiliation) from the teacher, has bouts of vomiting during the morning preparations for school (when mentally imagining a traumatic situation). Psychogenic vomiting also occurs in youth dysmorphophobia, due to dissatisfaction with one’s own appearance and an obsessive desire to lose weight. The regression mechanism is “burping up” in an infant when overexcited.
P) Sleep disorders - insomnia or, conversely, drowsiness, accompanied by the feeling that there was not enough sleep. In other words, after waking up, a person feels “broken”, sometimes he may even complain of muscle pain (a consequence of the fact that even in sleep he does not relax), describing his sensations “as if he had been carrying bags all night” or even “as if he were using sticks.” beat" (such self-punishment may be subconsciously desired by a critical Super-Ego).
C) Excessive urination, which usually occurs after panic attacks. (Here, stress disorders intersect with the manifestations of so-called diabetes insipidus and can aggravate the course of the latter).
T) A variety of sexual problems (both decreased sexual desire and potency, and in some cases hypersexuality). Often they can be caused by habitual tension in the muscles of the pelvic area. Thus, such problems, as V. Reich discovered, can be directly related simply to a person’s inability to relax in the literal sense, that is, to relieve muscle tension. The regression mechanism of potency disorders in men and female coldness is an infantile rejection of “adulthood”, of one’s gender role. This also includes functional disorders of the menstrual cycle in women (cycle irregularity, amenorrhea, premenstrual syndrome).
The main difference between all the psychosomatic disorders described above and ordinary bodily suffering is the nature of their course: distinct deterioration coincides with moments of violent emotional experiences. It is also important to emphasize the presence of personal predisposition, or personality-typological characteristics that predispose to the occurrence of psychosomatic disorders.
Such disorders can arise either in direct connection with stress (at a moment of acute stress or against the background of ongoing chronic neuropsychic tension), or have a delayed nature. In the latter case, the body begins to “crumble” some time after stressful events. This is the so-called “rebound syndrome”, which follows stress like the tail of a comet. Moreover, this can happen even if emotionally significant events were positive, associated with life successes - “achievement syndrome” caused by the experience of intense positive emotions and, most importantly, the acquisition of long-awaited joys that a person persistently strived for.
What do all these ailments lead to, besides feeling unwell? Physical suffering, in turn, causes mental suffering. Primary emotional problems develop into secondary psychological discomfort. We list the most common manifestations of psychosomatic, stress-related disorders at the psychological level:
A) anxiety, anxiety pure form. (Anxiety is nothing more than fear that is not directed at any specific thing.) Particularly characteristic of prolonged stress is the so-called “free-floating”, unmotivated anxiety, in other words, groundless fears about unlikely events that may never happen.
B) Depressed mood (up to a persistently low one, reaching the level of depression. From anxiety to depression there is one step...) Sudden mood swings are also possible, often accompanied by emotional imbalance - uncontrollable violent outbursts of emotions and “splashing out” of aggressiveness.
C) Unmotivated irritability and conflict, caused not by external reasons, but by the internal state of a person.
D) Violation of relationships with people. In accordance with K. Horney's typology, relationships can change from emotional coldness, insensitivity (movement “from people”) to open hostility towards others (movement “against people”). Or, on the contrary, an infantile dependence on others may arise (a movement “against people”) - a demonstration of one’s mental discord and helplessness, humiliation, a search for external support and sympathy.
D) The desire to isolate yourself from real life as a source of stress, isolate yourself from the everyday bustle, reminiscent of stressful events, and from the people associated with them - retire to an imaginary cell or “ivory tower”. Means of escaping reality can be various kinds of addictions, both chemical ones - be it alcohol or drugs, and addictive behavior - gambling or computer games, Internet addiction or various kinds of fanaticism.
Panic attacks are of a combined – both psychological and physiological – nature, ranging from the fear of losing control over oneself to the all-consuming fear of death. The regression mechanism is the revival of primary childhood fears (described below) in an adult.
Naturally, both groups of reasons described ultimately lead to a decrease in social activity and ability to work. First of all, due to constant (even at the beginning of the working day or after rest) and seemingly causeless fatigue associated with exhaustion of the nervous system. Increased distractibility and inability to concentrate also contribute to decreased performance.
Separately, it is necessary to say about fears, which are a form of release of internal psychological tension created by stress and at the same time a projection of childhood negative experiences. At least let's mention the most Universal forms of fears- such as:
1) Fear of death- primary, “animal” right-hemisphere fear. (In fact, this is not the fear of death as such, since fear, by definition, is associated with something specific and known. A person usually does not have the experience of dying - with the exception of those few who have experienced clinical death.) What is associated with death - first of all, fear of something unknown, life-threatening, beyond control human power and inexorable. This is the reverse side of the primary trauma of birth - the child’s fear of uncertainty, of a blind, ruthless force that disrupts his usual existence. (This fear accompanying the birth process is described by S. Grof (1994) as the experience of experiencing basic perinatal matrices). In adulthood, a child's fear of birth develops into a fear of everything unknown, uncontrollable, exciting and subjugating, of an all-powerful providence, and on a conscious level it is interpreted as a fear of death.
Adjacent here Fear of loneliness- children's fear of abandonment, called in psychoanalysis the fear of “losing an object”, the loss of a “protector” or “breadwinner”, but in fact - the fear of losing a mother (or a person replacing her who cares for the child), an acute feeling of one’s own helplessness and defenselessness. This is why panic attacks in adults are always alleviated in the presence of significant others who literally hold the patient’s hand, symbolically replacing parents.
2) Fear of losing control- “left-hemisphere.” The fear of losing control over oneself is a product of the harsh parental instructions dormant in the psyche of an adult, learned in childhood (Super-Ego, internal “Parent”). We can call it the fear of the rational part of consciousness of its own “disobedience.” After all, what most frightens such an educational-critical part of the personality is precisely the fear of doing something reprehensible, prohibited (something that the elders strictly forbade) due to the release of dormant in one’s own psyche hidden forces, not governed by logic and common sense (in fact, just the naughty inner “Child” - the childish, spontaneous and “playful” part of the personality).
Mechanisms of formation of psychological problems and psychosomatic disorders: Physical and psychological problems as disorders of psychological adaptation. Somatic (clinical) approach to psychological problems...
Psychosomatics(from the Greek psyche - soul and soma - body) - a section of medical psychology that studies mental factors in the development of functional and organic somatic disorders.
Psychosomatic medicine gained rapid spread and development at the beginning of the 20th century. At this time, millions of cases were recorded of so-called “functional” patients, “difficult patients”, whose somatic complaints were not confirmed by objective research, and whose treatment with orthodox medications was ineffective. First of all, it was necessary to correct affective states that affected the interpersonal relationships of patients, that is, psychotherapy, psychological counseling.
Among changes in somatic well-being due to emotional influence, one should distinguish between non-pathological psychosomatic reactions, psychosomatic diseases, the influence of the emotional state on the occurrence and course of somatic diseases, and somatoform mental disorders.
In the International Classification of Diseases, 10th edition, the term “psychosomatic” is not used in relation to any diseases, so as not to create the impression that psychosomatic relationships may not be significant in other disorders.
The psychosomatic approach as a principle of therapeutic activity presupposes a holistic perception of the sick person, with all his personal characteristics, cultural norms and values, biological hereditary and constitutional characteristics, environmental influences and interpersonal relationships. At the end of the 20th – beginning of the 21st centuries, the biopsychosocial concept of disease, which is based on the principles of multifactoriality in understanding the causes of the onset and course of the disease, is becoming increasingly recognized in medicine. Thus, the psychosomatic approach is practically generally acceptable today.
Psychosomatic diseases arise as a result of stress caused by long-term and insurmountable psychotraumas, internal conflict between the individual’s motives of equal intensity, but differently directed. It is assumed that some types of motivational conflicts are specific to certain forms of psychosomatic diseases. Thus, hypertension is associated with the presence of a conflict between high social control of behavior and the individual’s unfulfilled need for power. An unfulfilled need causes aggressiveness, which a person cannot demonstrate through social attitudes. Moreover, unlike neuroses, which are also based on intrapsychic conflict, with psychosomatic diseases there is a double repression - not only of a motive unacceptable to consciousness, but also of neurotic anxiety and all neurotic behavior.
There is a close system of somatopsychic and psychosomatic relationships that must be recognized and taken into account in the treatment of the patient. When considering the relationship between somatic and mental states, it is advisable to distinguish the following types:
1. Psychological factors as the cause of somatic illness (actually psychosomatic illnesses).
2. Mental disorders manifested by somatic symptoms (somatoform disorders).
3 Mental consequences of somatic illness (including psychological reaction to the fact of somatic illness).
4 Mental disorder and physical illness, coincidentally coincidental in time.
5. Somatic complications of mental disorders.
Psychological factors play a role in the formation of various diseases, such as migraines, endocrine disorders, malignant neoplasms, etc. Among them, real psychosomatosis should be distinguished, the occurrence of which is determined by mental factors and the prevention of which should be aimed primarily at eliminating and correcting emotional overstrain (psychotherapy and psychopharmacology ), and other diseases on the dynamics of which mental and behavioral factors have an important influence, changing the nonspecific resistance of the body, but are not the root cause of their occurrence. For example, it is known that the influence of psycho-emotional stress can reduce immune reactivity, which will increase the likelihood of diseases, including infectious ones.
Representatives of psychoanalysis approach the explanation of psychosomatic pathology, focusing on the predominance in patients with psychosomatic symptoms of repression of emotional experiences (a protective psychological mechanism that manifests itself in the subconscious exclusion of unacceptable thoughts or emotions from consciousness), which then manifest themselves as somatic symptoms. However, this ignores organic pathology, and in practice one cannot neglect the fact that patients develop organic lesions over time, and after the onset of the disease, psychotherapy alone is not enough, but appropriate treatment using modern pharmacological agents, and sometimes surgical assistance, is necessary.
A scientific explanation of psychosomatic relationships is possible on the basis of the conditioned reflex theory of I.P. Pavlova. Russian neurophysiologist P.K. Anokhin developed the biological theory of functional systems - the concept of organizing processes in an entire organism that interacts with the environment. The theory is based on the idea of function as the organism achieving an adaptive result in interactions with the environment. In the light of this theory, any emotional reaction is considered as an integral functional system that unites the cerebral cortex, subcortical formations and corresponding somatic links.
From the standpoint of neurophysiology, they are involved in emotional processes as central (thalamus, limbic system, activation and reward structures) and peripheral structures (catecholamines, adrenal hormones, autonomic nervous system). Stimuli of excessive strength and duration alter the functional state of the central nervous system and peripheral nervous system. This can result in functional impairments and so-called “places of least resistance” (locus minoris resistentiae). There is a system of constant feedback that determines the possibility of therapeutic, healing effects of the emotional factor.
An unresolved conflict of motives (as well as unresolved stress) ultimately gives rise to a reaction of capitulation, a refusal to search, which creates the most common precondition for the development of psychosomatic diseases in the form of masked depression. The defeat of certain organs and systems is caused by genetic factors or features of ontogenetic development.
The importance of the doctor’s understanding of the essence of protective psychological mechanisms requires a brief description of them in this section. Defense mechanisms are divided into primitive, or immature (splitting, projection, idealization, identification), and more mature (sublimation, rationalization, etc.). However, neither the number of protection options (several dozen of them are described), nor their classification, nor their names are generally accepted.
One group combines defense options that reduce the level of anxiety, but do not change the nature of the impulses. These include: suppression or repression from awareness of unacceptable motives or feelings, negation the source or feeling of anxiety itself; projection or transference of one's desires or feelings onto others; identification- imitation of another person with attribution of his qualities to oneself; inhibition- blocking in behavior and consciousness all manifestations associated with anxiety.
Another group includes forms of defense in which mechanisms are triggered that reduce the severity of anxiety and at the same time change the direction of impulses: self-aggression- turning hostility towards oneself; reversion- polar reversal, or a change in motives and feelings to the opposite; regression- reduction, or return to early, childhood forms of response; sublimation- transformation of unacceptable ways of satisfying needs into other forms - for example, in the form of creativity in art or science.
Let's consider 9 main forms of psychological defense, regardless of their classification.
1. Repression. Repression means suppression or exclusion from consciousness of unpleasant or unacceptable events and phenomena, i.e., removal from consciousness of those moments and information that cause anxiety. With neuroses, for example, the main event that caused it is often repressed. Such psychological experiments are interesting in this regard. The subjects were given photographs that depicted specific conflict situations that were close to their experiences. It was expected that the subjects would tell their contents, but they seemed to “forget” these photographs and put them aside. When the corresponding photographs were reproduced in a situation of hypnosis, the protection was removed and the photographs produced an effect adequate to their content. A similar defense mechanism underlies the widespread phenomenon when other people's shortcomings in behavior are noticed, and their own are repressed. In other experiments, subjects were offered tests to achieve a certain success in performing a particular task; they remembered only those tasks that they completed well, and “forgot”, i.e., crowded out uncompleted tasks.
2. Substitution- reorientation from one object (topic) causing anxiety and unpleasant experiences to another. This version of psychological defense can be represented by the following simple examples. After a conflict with a boss at work or a quarrel with a loved one, an individual unleashes anger on family members (at the same time, rationalization often takes place, which will be discussed below). A man crumples a piece of paper during an exciting conversation. A girl, when her friend says “your boyfriend always lets you down,” throws away the cat sitting on her lap.
3. Rationalization. In this case, we are talking about an attempt to rationally justify desires and actions caused by such a reason, the recognition of which would threaten the loss of self-esteem. There can be many examples here. If a stingy person is asked for a loan, he will always justify why he cannot lend (for educational reasons, etc.); if a person is unpleasant, then it is always easy to find a lot of shortcomings in him, although hostility may not be associated with them at all; The patient may explain his interest in medical literature by the need to broaden his horizons.
4. Projection. Defense in the form of projection is the unconscious transference of one’s own unacceptable feelings and drives to another person, attributing one’s socially unapproved impulses, desires, motives, actions and qualities to others. A striking example of this is the behavior of a wealthy young man who places his mother in a nursing home and is indignant that the staff treats her indifferently or poorly.
Projection to a certain extent simplifies behavior, eliminating the need in everyday life to evaluate one’s actions every time. We often transfer our behavior onto other people, projecting our emotions onto them. If a person is calm, self-confident, and friendly, then in his eyes those around him share his goodwill, and vice versa - a tense, frustrated person, dissatisfied in his desires, is hostile and attributes and projects this hostility to others.
5. Somatization. This form of protection is expressed in getting out of a difficult situation by fixating on the state of one’s health (schoolchildren “get sick” before tests - the simplest example). In these cases, the main importance is the benefit from the disease - increased attention and reduced demands from loved ones. In more severe cases, this form of protection takes on a chronic nature, and, as a rule, there is an exaggerated attention to one’s health, an exaggeration of the severity of the disease, even to the point of creating one’s own concepts of the disease, and a hypochondriacal syndrome can form.
6. Reactive education. In this case, we are talking about replacing unacceptable trends with the exact opposite. Thus, rejected love is often expressed in hatred towards former object love, boys try to offend the girls they like, secret envious people often quite sincerely count themselves among the devoted admirers of the one they envy.
7. Sublimation. With this form of psychological defense, unacceptable impulses are transformed into socially acceptable forms of instinctive needs that cannot be realized in an acceptable way out and way of expression (for example, childless people have animals). In this regard, a hobby is of interest, which for some is a way of realizing the most incredible motives and drives. Selfish and even “forbidden” goals can be sublimated by active activity in art, literature, religion, and science.
Aggressive impulses, for example, can be sublimated into sports or political activity. But we are talking about psychological defense itself when the individual does not realize that his activity is determined by hidden impulses, which sometimes have a biological and egoistic basis.
8. Regression. In this case, we are talking about a return to primitive forms of response and behavior. This form of psychological defense manifests itself especially often in children. For example, when deprived of parents, children often exhibit behavior consistent with developmental delay: a child who began to walk suddenly stops walking, or the child resumes enuresis that occurred in infancy. We can also mention the habit of thumb sucking in difficult situations (this feature sometimes manifests itself not only in children, but also in adults). Elements of psychological defense in the form of regression can also be observed in some mental illnesses.
9. Negation. This form of defense is a defense mechanism by which impossible desires, motives and intentions, as well as facts and actions are not recognized, rejected by unconsciously denying their existence, i.e., in denial, the real phenomenon is considered non-existent. It should be emphasized, however, that denial does not involve a conscious attempt to renounce or retreat, as in pretense, simulation, or lying.
In everyday life, most real situations often involve the use of several forms of psychological defense simultaneously. This must be taken into account when a doctor works with both healthy and sick people.
The mechanisms of psychological defense outlined above are part of psychological adaptation processes. Adaptation is a property of any living self-regulating system, which determines its resistance to change environment. Highlight physiological, psychological, social adaptation of the individual. Violation of adaptation to environmental conditions is called maladjustment . Adverse external influences (stress) that exceed adaptation capabilities are called distress.
In response to psycho-emotional stimuli, various non-pathological psychosomatic reactions arise (visceral, sensory, etc.). Psychosomatic reactions can occur not only in response to mental, emotionally significant influences, but also to the direct effects of stimuli (for example, the sight of a lemon). Ideas can also influence a person’s somatic state. Psycho-emotional factors can cause the following physiological disorders in various organs and systems of the body:
a) in the cardiovascular system - increased heart rate, changes in blood pressure, vascular spasm;
b) in the respiratory system - its delay, slowdown or acceleration;
c) in the digestive tract - vomiting, diarrhea, constipation, increased salivation, dry mouth;
d) in the sexual sphere - increased erection, weakness of erection, swelling of the clitoris and lubrication (secretion of the genital organs), anorgasmia;
e) in the muscles – involuntary reactions: muscle tension, trembling;
f) in the autonomic system - sweating, hyperemia, etc.
Psychosomatic diseases - these are somatic diseases, in the occurrence and course of which psychological factors play a decisive role. The cause of psychosomatosis is affective (emotional) stress (conflicts, dissatisfaction, anger, fear, anxiety, etc.) subject to the presence of certain personal characteristics. These diseases are often called “major” psychosomatic diseases, emphasizing the severity of the disease and the leading role of the psychogenic factor in their occurrence.
Actually psychosomatic diseases are characterized by the following features:
Mental stress is decisive in provoking;
After manifestation, the disease takes a chronic or recurrent course;
First appearance at any age (but more often in late adolescence).
Historically, the classic pictures of seven diseases are classified as psychosomatic, namely: essential hypertension; peptic ulcer; bronchial asthma; neurodermatitis; thyrotoxicosis; ulcerative colitis; rheumatoid arthritis.
Characteristics of psychosomatic disorders.
The search for psychological characteristics responsible for the occurrence of psychosomatic diseases has today led to the description of characterological traits that are found in different combinations in patients with different diseases. These are traits such as isolation, restraint, anxiety, sensitivity, etc. Below are some features of patients with certain psychosomatic disorders.
Hypertension (essential arterial hypertension). The main properties of a personality prone to the formation of essential hypertension are considered to be intrapersonal conflict, interpersonal tension between aggressive impulses, on the one hand, and a feeling of dependence, on the other. The appearance of hypertension is due to the desire to openly express hostility with a simultaneous need for passive and adaptive behavior. This conflict can be characterized as a conflict between such contradictory personal aspirations as a simultaneous focus on directness, honesty and frankness in communication and politeness, courtesy and avoidance of conflicts. Under stress, such a person tends to restrain his own irritability and suppress the desire to respond to the offender. Suppressing negative emotions in a person during a period of stress, accompanied by a natural increase in blood pressure, can worsen a person’s general condition and even contribute to the development of a stroke.
When examining the mental state of patients with arterial hypertension in combination with daily blood pressure monitoring, it was revealed that at the early stage of arterial hypertension after an increase in blood pressure in patients, there is a decrease in the level of anxiety, which confirms the compensatory role of a rise in blood pressure due to prolonged psycho-emotional stress.
In the initial stage of hypertension, most patients adequately assess their health status and correctly perceive the doctor’s recommendations and prescriptions. Some patients with anxious and suspicious traits perceive an increase in blood pressure as a tragedy, a catastrophe. The mood of such patients is reduced, attention is fixed on sensations, the range of interests is narrowed, limited to the disease.
In another group of patients, the diagnosis of hypertension will not cause any reaction; they ignore the disease and refuse treatment. This attitude towards the disease is observed mainly in people who abuse alcohol.
It should be noted that there is no parallelism between the level of blood pressure (BP) and the likelihood of developing mental disorders. When examining the mental state of patients with arterial hypertension in combination with 24-hour blood pressure monitoring, for the first time, indicators of 24-hour blood pressure monitoring were established that are significant in relation to the prognosis of the development of mental disorders in this disease. These are high variability of blood pressure during the day and disruption of the circadian rhythm of blood pressure fluctuations: increased or absent physiological nighttime decrease in blood pressure levels.
A patient with hypertension should explain the cause of his condition, say that his nervous system disorders are of a functional nature, that they are temporary and with appropriate systematic treatment, the affected function will be restored.
Coronary heart disease. For many years, emotional stress was thought to predispose to coronary heart disease. The literature describes a “coronal personality.” These types of ideas are difficult to test because only prospective studies can separate the psychological factors that contribute to the development of heart disease from the psychological consequences of the disease itself. Research conducted in the 1980s focused on several groups of possible risk factors, which include chronic emotional disorders, socioeconomic difficulties, overwork or other long-term aggressors, and type A behavior patterns. Most supported evidence of a Type A pattern of behavior characterized by such basic traits as hostility, excessive desire for competition, ambition, a constant feeling of lack of time and a focus on restrictions and prohibitions. When conducting studies on primary and secondary prevention, the main approach was to eliminate risk factors such as smoking, poor diet, and insufficient physical activity.
Angina pectoris . Angina attacks are often triggered by emotions such as anxiety, anger and agitation. The sensations experienced during an attack are at times extremely terrifying, and often the patient becomes overly cautious over time, despite all the assurances of the doctors and despite their efforts to encourage him to return to his normal active lifestyle. Angina may be accompanied by atypical chest pain and shortness of breath caused by anxiety or hyperventilation. In many cases, there is a discrepancy between the patient's actual exercise capacity, as determined by objective measurements, and their complaints of chest pain and activity limitation.
A good effect in overcoming these problems is usually achieved by conservative treatment in combination with regular physical exercises appropriate to the patient’s condition. Some patients are helped to regain self-confidence by behavioral therapy, carried out according to an individually developed program.
Cardiophobia. One of the psychovegetative syndromes that is often observed in medical practice is cardiophobia. Discomfort and unusual sensations in the left half of the chest, which first arise in a situation that is psychologically traumatic or even in its absence after prolonged asthenia, determine the increasing anxiety and vigilance of patients, fixation on the activity of the heart, which increases confidence in the presence of a serious heart disease and fear of death. At first, vague concern and growing affective tension, anxiety, suspicion, fears, constitutional, as well as acquired personality characteristics become the basis for the development of an acute cardiophobic attack. The unbearable, vital fear that patients feel in connection with cardiovascular disorders cannot be compared with ordinary human sensations and experiences, either in their intensity or in their nature. The feeling of imminent death becomes the only existing reality for the patient. And the obvious fact that dozens of similar heart attacks he had previously suffered did not lead to either a heart attack or heart failure does not matter to him. Since it has long been known that it is scary not to die - it is scary to die, the fate of these patients who “die” repeatedly is truly tragic. Here rational psychotherapy and suggestion are of particular importance. In some cases, even the patient’s life depends on their correct use by doctors.
Dyspnea, which is caused by many respiratory and cardiac disorders, may increase under the influence of psychological factors. In some cases, shortness of breath is purely psychological in origin: a typical example is hyperventilation associated with an anxiety disorder.
Asthma. It has been suggested that asthma is caused by unresolved emotional conflicts associated with subordinate relationships, but there is no satisfactory evidence to support this idea. In bronchial asthma, there are contradictions between the “desire for tenderness” and the “fear of tenderness.” This conflict is described as a “own-give” conflict. People suffering from bronchial asthma often have hysterical or hypochondriacal character traits, but they are not able to “release their anger into the air,” which provokes attacks of suffocation. Also noted is a quality of asthmatics such as hypersensitivity, especially to odors, which is associated with reduced accuracy.
Compelling evidence suggests that emotions such as anger, fear and agitation can trigger and increase individual attacks in patients with asthma. The literature has reported that children who had severe asthma and died from the disease were more likely to have chronic psychological and family problems than other children with severe asthma.
Mental morbidity among children with asthma is not much higher than among the general child population. However, if such children develop psychological problems, then treatment, as a rule, becomes significantly more complicated.
Attempts have been made to treat asthma using psychotherapy and behavioral therapy, but there is no convincing evidence that these methods are more effective than simple advice and support. Individual and family psychotherapy may be beneficial in treating children with asthma where psychological factors are important.
Gastritis. In patients with gastritis and peptic ulcer disease, a unique character is formed in early childhood, leading to the fact that the individual experiences a constant need for protection, support and care in adulthood. At the same time, he is simultaneously instilled with respect for the strength, autonomy and independence that he strives for. As a result, there is a clash of two mutually exclusive needs (care and independence), which leads to an insoluble conflict.
Peptic ulcer . People who get stomach ulcers and duodenum, have certain characterological features. Among them there are often people with violent emotional reactions, categorical judgments, and straightforwardness in assessing the actions of others. Another category of patients is not prone to external manifestations of emotions. Often there are gloomy, dissatisfied, distrustful people. Some authors associate peptic ulcer disease with an unacceptable need for protection and intercession for self-perception.
Strong prolonged affects, negative emotions, such as constant fear, great grief, severe fright with overstrain and depletion of cortical activity can lead to prolonged spasm of the blood vessels of the stomach wall, with reduced resistance of its mucous membrane to the action of hyperacid gastric juice, leading to the occurrence of ulcers . Further development peptic ulcer disease depends both on the action of these factors, which does not stop, and on the occurrence of pain impulses from the interoceptors of the affected organ. Psychotherapy greatly influences the course of the disease and the effectiveness of treatment.
Colitis. In ulcerative colitis, the onset of the disease is observed after experiences of “loss of an object” and “catastrophes of experience.” Patients have low self-esteem, excessive sensitivity to their own failures and a strong desire for dependence and guardianship. Illness is often seen as the equivalent of sadness.
Diabetes mellitus . The personality of a patient with diabetes is described as necessarily including a feeling of chronic dissatisfaction. However, it is believed that, unlike representatives of other psychosomatic diseases, there is no specific diabetic personality type.
Neurodermatitis. Neurodermatitis of psychosomatic origin includes eczema and psoriasis. Patients are often characterized by passivity and find it difficult to assert themselves.
Diseases of the musculoskeletal system. For patients with rheumatoid arthritis, the patient’s “frozen and exaggerated position” and demonstration of a high level of self-control are considered specific. There is also a tendency towards self-sacrifice and an exaggerated willingness to help others. At the same time, “aggressive coloring of assistance” is noted.
Principles of prevention of psychosomatic diseases
Therapeutic tactics in the treatment of psychosomatic diseases include the main role of somatologists and appropriate methods of therapy. However, psychotherapy plays an important role in preventing the occurrence of these diseases and at all stages of treatment and rehabilitation. In the prevention of psychosomatic diseases, an important role is played by the timely identification of personal predisposition and the conduct of long-term person-oriented psychotherapy with the help of a psychotherapist. General practitioners and family medicine doctors must master themselves and teach patients the skills of mental self-regulation, autogenic training for the purpose of mobilization or relaxation in stressful situations.
Another approach is applied to the treatment of neurotic and somatoform disorders, when the patient’s somatic complaints are associated with functional somatic disorders, the main cause of which is mental illness. In these cases, treatment is carried out by a psychiatrist using psychotherapy and psychopharmacotherapy.
Now about this in more detail:
Conversion disorder– a psychogenic disease with diverse symptoms, capable of simulating a variety of diseases, in the absence of clear laboratory and instrumental data.
Conversion disorder occurs in absolutely different people at any age. There is a misconception that they mainly affect women - this is not true. Modern research show that there is no difference between the sexes in this matter.
More recently, the name “Hysterical neurosis” was used to replace this term; today this definition is not used.
It is believed that conversion disorders occur in healthy people under the influence of several factors:
Increased sensitivity to bodily sensations
- intolerance of unpleasant emotions
- special conditions education in childhood (inconsistency of parents)
The most characteristic manifestations of conversion disorders:
- paresis and paralysis (lack of strength in the limbs)
- Sensory disturbances such as hypoesthesia, hyperesthesia, anesthesia or paresthesia (unpleasant sensations in the body)
- hyperkinesis (twitching, obsessive movements)
- astasia-abasia (inability to stand and walk)
- seizures resembling epileptic
In the process of upbringing and development by parents, the environment and social media, behavioral stereotypes are formed to satisfy basic needs. In the first years of life, a child completely copies the behavior of his parents, no matter whether it is successful or not. For example, in families where people are often offended, there is a peculiar mechanism for resolving conflicts, when one family member, in order to achieve his goal, is demonstratively silent and does not make contact, while experiencing strong feeling grievances. All this is aimed at making the other member feel guilty. In a family, this very often helps and works. But when you go out into the open world, these habits are unconsciously transferred to strangers. In another environment, people will not succumb to such manipulations. An adult child will repeat ineffective behavior over and over again, while strengthening it, increasingly feeling resentment, tension throughout the body, a sense of pressure and disappointment in life. Constantly being in this state will inevitably affect your physical well-being.
This is just one example of the development of such disorders; their diversity and manifestation are always unique.
Without breaking the “strong circle” and recognizing errors in response, these disorders cannot be completely overcome.
Somatization disorders
Somatization disorders are disorders in which the emotional reaction becomes more important and significant for the individual than the reason itself that caused it.
In other words, this is a condition when it seems that we are suffering from some kind of “nervous disorder”, but in fact, behind this lies a completely different psychological illness.
Most often, the “gray eminence” of psychological life is depression and anxiety disorders.
They most often appear in the form of:
- pain (usually persistent, not changing localization, little dependent on external factors)
- dyspeptic disorders (diarrhea, constipation)
- heart rhythm disturbances (sinus arrhythmia, extrasystole)
- hair loss
- anorexia
- weight loss
- panic attacks
People suffering from somatization disorders often consider themselves ordinary patients and rarely turn to psychotherapists.
Naturally, such a “conservative” approach practically does not lead to recovery; on the contrary, the impact of psychotherapy or special drugs on the true cause causes a quick and lasting effect.
In the treatment of somatization disorders, it is necessary to take into account the cause of the primary disorder (most often depression), which is described in detail in the corresponding section.
Psychosomatic diseases
Psychosomatic diseases (psychosomatosis) are organic somatic diseases that arise as a result of the action of psychogenic factors.
The following diseases can be psychosomatic:
- Hypertension
- Thyrotoxicosis
- Bronchial asthma
- Coronary heart disease
- Neurodermatitis
- Rheumatoid arthritis
- Peptic ulcer(stomach or duodenum)
- Nonspecific ulcerative colitis
- Diabetes mellitus type II
- Oncological diseases
The following signs indicate the psychosomatic nature of the disease:
- the occurrence of the disease against the background of an acute or chronic psychotraumatic situation;
- dependence of the occurrence of exacerbations on psychogenic factors;
- the absence of other obvious reasons for the development of this disease (infection, intoxication, allergies, pathological heredity, etc.).
Psychosomatic diseases can develop through several mechanisms:
- Chronic hyperstimulation of one of the parts of the autonomic nervous system during long-term emotional experiences (for example, with anger, the sympathetic part of the ANS is stimulated, with anxiety - the parasympathetic).
- Local microcirculation disorders in internal organs due to chronic vascular spasm.
- Hormonal changes that accompany persistent emotional disturbances (for example, hypercortisolemia in depression, leading to increased blood sugar levels).
- Violations of general immunity in some chronic emotional disorders (for example, decreased immunity due to increased production of steroid hormones and insufficient production of melatonin in depression).
- Blood composition disorders during chronic psychoemotional stress (increased content of saturated fatty acids and fibrinogen under the influence of increased production of ACTH).
- Activation under the influence of stress of lipid peroxidation, which has a damaging effect on the biomembranes of the whole organism.
- Failure under the influence of stress of circadian biorhythms, as a result – an imbalance in the functioning of the autonomic nervous system.
All of the above mechanisms are given to provide an approximate explanation of the causes of certain psychosomatic disorders. I strongly recommend not to engage in self-diagnosis and self-medication, but to seek help from a specialist.
Nowadays, doctors often detect difficultly diagnosed diseases in patients, without obvious reasons for their manifestation. Many ailments are very insidious: the patient has not identified any physical factors for the onset and progression of the disease. For example, tests are normal and there are no hereditary pathologies. Then specialists think about a possible pathology of a psychosomatic nature.
Psychosomatic diseases have different hidden reasons and a special approach to diagnosis to begin treatment of psychosomatic diseases. The effect of mental health disorders on physical organs has been studied since ancient times. According to the ancient Greek philosopher Plato, the body and soul are one. For more than two thousand years, humanity has been trying to learn more deeply about the influence of emotions on the physical state of the human body.
Factors causing psychosomatic diseases
Any treatment of psychosomatic diseases begins after a complete diagnosis of the patient’s body. Often the root of the problem lies in a psychological factor - severe stress suffered. Researchers in the field of psychosomatics argue that even the slightest negative emotions can significantly harm the body. If a person keeps everything unsaid to himself, sooner or later psychological suppression will produce negative results. Over time, bad thoughts burn out inside a person, destroying, according to adherents of psychomatics, the body itself. Ailments appear that, according to the logic of things, the patient should not have.
Every year, medical statistics indicate an increase in psychosomatic diseases among the population. More than 40% of illnesses are provoked by internal conflicts and mental trauma. Viral infections are not capable of inflicting so much great harm as a depressed psychological state. Scientists have conducted similar studies on animals - the trend is the same, although there are many differences in humans. The key one is the ability to recognize and control your emotions. But alas, I am high intelligence It’s not typical to have 100% control own feelings. It is these emotional experiences that can have a devastating impact on our health.
If the patient suspects a disease of this nature, then treatment of psychosomatic diseases will begin with a course of psychotherapy, which will help to identify all the hidden fears, anger, sadness that have resulted in a dangerous illness. In some cases, it is quite easy for a psychosomatic specialist to identify the root of the problem. For example, a patient shared the true reason for his depressed state of mind due to the death of a loved one and fears for his health. In most stories, it is much more difficult to find the chain of illness and cure a psychosomatic illness.
Symptoms of psychosomatic diseases
Not every specialist will be able to immediately suspect the patient’s true causes in order to begin treatment for psychosomatic diseases in a timely manner. Often such ailments do not have any special features outwardly. For example, gastritis can be bacterial and somatic in nature - this cannot be detected overnight. In some patients, the stomach is actually affected by the Helicobacter bacteria, while others felt acute cramps after another stressful situation. Diseases of different organ systems in most cases are directly related to the dynamics of the patient’s mental state:
- vascular-cardiac system;
- nervous system;
- immunity.
After a thorough diagnosis of the patient, a regular doctor will prescribe drug therapy to alleviate the condition and cure the disease. After the first symptoms subside, the patient is confident that he has been cured, losing sight of psychological reasons diseases. Towards the end of drug therapy, stronger pharmacological drugs and procedures will be needed to treat psychosomatic diseases. Several years after “wandering” in the diagnosis, the patient acquires a chronic form of his problem, plus the effects side effects from addiction to medicines. The patient loses hope of a complete cure, not realizing that for complete healing he needs to turn to a professional psychotherapist. It is this specialist who will “unblock” chronic stress, and other diseases will go away with it.
The key nuance lies in the following: patients sometimes tend to remain silent about mental problems due to shyness, and the doctor does not ask about the psychological state, considering this tactlessness on his part.
Psychosomatic diseases are not amenable to traditional therapy - you need to find out the psychological reasons and begin treatment with a psychotherapeutic bias. The key symptom of diseases of this spectrum is the inaction of traditional medicine. If a patient is not going through a good period in his personal life, it is advisable for him to immediately begin his journey of examination with a psychotherapist to quickly identify disorders in the body.
What ailments are classified as psychosomatic diseases
Many doctors and patients lose sight of the psychological essence of the disease. The patient is confident that the next stress will be fleeting, and doctors are looking for new ways to heal, for example, from bronchial asthma. Few people know that this disease in most cases is caused by psychological disorders. This also applies to other diseases:
- hyperventilation syndrome;
- essential hypertension;
- cardiophobic neurosis;
- ischemic heart problems;
- myocardial infarction;
- arrhythmias;
- vegetative-vascular dystonia.
By the way, the last disease on the list is completely treatable without drug therapy due to its 100% psychosomatic nature.
The study of psychosomatic diseases is most relevant in our time. Young people suffer from numerous gastrointestinal disorders and skin diseases. This is a direct result of the influence of the psyche on human health. As for young girls, due to psychological instability they suffer from many gynecological pathologies which lead to subsequent infertility. Stress is also a common culprit of endocrine disruption. It can cause diabetes mellitus, hyperthyroidism and hypothyroidism. Rheumatic and sexual ailments also arise in most cases due to psychomatics.
Risk groups for patients with psychosomatic diseases
The key contingent of patients are hidden people who keep their inner emotions from the outside world. Among melancholic people there are many individuals who, with external calm, hide the raging volcanoes in their souls. Even the most balanced and calm people sometimes lose their temper. Such situations can lead to the onset of one or another psychosomatic disease.
The tendency to veiled diseases manifests itself in childhood or adolescence. Children and adolescents are not yet mentally stable enough to overcome stress on their own without consequences for the physiological health of the body. But in our society there are unique people who are able to live safely into adulthood without getting hung up on their problems. They also suffer from psychosomatics, but diagnosis for them will be lengthy and difficult.
For example, alcoholics will not be able to cope with their addiction until they believe in themselves as individuals. The roots of the problem may come from childhood, when parents set the bar too high for their child. In adulthood, some inconsistency leads to drowning problems with alcohol.
Have you noticed that your body catches a cold faster precisely when you are not in a good mood and have a good attitude towards life? It has also been scientifically proven that anemia occurs due to fear of the unknown. ENT diseases often occur in uncommunicative patients, for whom expressing their opinion is a real problem. A doomed psychological state leads to the manifestation of gastritis. Women who are afraid of independence in decision-making suffer from infertility. As you can see, lack of self-confidence can lead to psychosomatic illnesses.
What is the course of treatment for psychosomatic illnesses?
General methods are not acceptable for the treatment of psychosomatics. An individual approach must be applied to each patient. First of all, the doctor must find out the nature of the disease - physiological or psychosomatic. An experienced psychotherapist will help with this. Even the patient himself can find out the true cause of his condition. Psychosomatics cannot be led to simulation or to inventing a problem. This is a truly destructive process that requires immediate treatment, which is not like classical drug therapy.
If doctors were able to identify a psychosomatic illness in your child, this is a reason to check the psychological state of all family members. To eliminate psychosomatics, you need to find out about the cause, and it often lies in a poor home environment. Even for the treatment of mature patients, it is necessary to involve relatives. Psychotherapists work with entire families, advising them to defuse their lifestyle by changing their work environment and even moving.
In most cases with medical practice the somatic aspect of the problem is hidden so deeply that it requires a psychotherapeutic course. Nowadays, the effectiveness of this type of treatment in getting rid of bronchial asthma, various allergies and gastrointestinal ailments has been proven. The right combination of psychotherapy and medication can restore the patient’s lost health without returning to illness. The main thing is for patients to remember diseases that require additional consultation with a psychotherapist. Many people are lucky enough to get relief from their symptoms after a few sessions of psychotherapy.