The psychosomatic patient

The psychosomatic patient

The study of Psychosomatic Disorders It has always raised problems of a theoretical-clinical nature, which have led to numerous studies and controversies.


  • 1 What is Psychosomatic Disorder
  • 2 Common characteristics of Psychosomatic Disorder
  • 3 Psychosomatic Disorder Treatment

What is Psychosomatic Disorder

We could define this psychosomatic disorder as the experience of conflicts through various somatic reactions: ulcers, anorexia, heart disease, colitis, asthma, insomnia ...

In-patient care is frequent in patients who have undergone a large number of diagnoses, examinations and treatments, without obtaining satisfactory post-treatment results.

The same symptoms in different patients do not guarantee the same structure. What is observed is that there is no common base structure in this type of patients, as we can find in other clinical pictures. From this we can deduce the importance of a good differential diagnosis both medical and psychodynamic.

All, at any given time, we have suffered psychosomatic symptoms. There are people who although they would not be defined as a psychosomatic patient, in crisis situations they end up aggravating or suffering a disease; But there is a specific type of person who has a special predisposition to develop a psychosomatic disorder.

In addition to the difficulties that we may encounter in the diagnosis, not all patients can initiate psychotherapy, given that there is a minimum desire to want to discover those unknown contents that cause so much discomfort.

Common characteristics of Psychosomatic Disorder

From the studies that have been carried out throughout history, a series of characteristics can be inferred, which, in my opinion, make the psychosomatic patient be recognized.

These characteristics may seem exaggerated, since they correspond to a pure psychosomatic patient, and it is very difficult, practically impossible, that we find in clinical practice, where it is usual to find psychosomatic symptoms.

This type of patient has a special relationship with reality, which is generally overfitted, living objectively and impersonally. They show hyperactivity behaviors. They have a compulsive inclination to work, are super-demanding and hypereffective, are dedicated to achieving external successes, and induce others to be required. There is a predominance of the principle of reality over the principle of pleasure. An example of this can be seen in many women who live with an exclusive dedication to the family, and who spend the day obsessed with cleaning. Or in many executives who do not have time to leave work, and have made this their life.

As for the affections they present disconnection (alexithymia). Present difficulties in detecting, discriminating, and expressing emotions, and those they express, are at a very corporal level. This, at the same time, leads us to a thought stripped of emotional meaning and meaning, whose emotional representations are poor, scarce and repetitive. They lose interest in the past and the future, and it is the factual and the actual that is imposed. We can also observe that they maintain a superficial contact in their relationships.

To illustrate this type of features, I will explain the example of a patient who, worried about how others could see it, said: “I don't want to give anyone reason to talk, I want my daughter and me to be spotless" This made, that weekly made a compulsive expense in clothes, since a garment could not be used on more than one occasion.

This does not mean that they have low intellectual level, because they can become very rational and intellectualize, but there is a shortage of dreams and creative thinking, and if there are any, they do not fulfill the function of elaborating and symbolizing latent thoughts, but that of evacuating the latent content. There is a decrease in the use of symbols in the transmission of psychic processes and the associative chains are poor, which is why psychotherapeutic treatment is not without difficulties, being usual that during the sessions they state: “I don't know what else I have to explain, if you don't ask me, ” or "Well, now that I have to do, I don't know how talking can help me cure my illness".

These patients also have many difficulties in developing the separations. In many cases the appearance of psychosomatic symptomatology appears after a loss or separation. They live as dangerous, as it can lead to primitive disorganizations.

Psychosomatic Disorder Treatment

The treatment we consider most appropriate is psychotherapy, often accompanied by a multidisciplinary approach, where pharmacological treatment can be instituted if deemed necessary, since it is necessary to keep in mind, in this type of disorders, that the physiological ailment is real.

It has been proven that the psychotherapeutic accompaniment, in this type of patients, with the aim of identifying and developing the different emotions, causes them to experience a gradual improvement of psychosomatic symptomatology.


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