OTHER DISORDERS

Somatic Symptom Disorder

Biological and psychological factors are often intertwined, and the somatic symptom disorder is a prime example of the fluid boundary between mind and body!

But what exactly is a Somatic Symptom Disorder?  

‘Soma’ means ‘body’, so putting this together, it basically means that psychological problems take on a physiological cause. In other words, people with Somatic Symptom Disorder experience bodily symptoms without any apparent physical or organic cause for it. Instead, these bodily symptoms seem to be the result of psychological factors. 

Note: These bodily symptoms are not intentionally produced nor are they under voluntary control. 

An extreme but obvious example of somatic symptom disorder is pseudocyesis, otherwise known as a false pregnancy. In this situation, a woman firmly believes that she is expecting a baby even when physical examinations and tests clearly show otherwise. In other cases, however, somatic symptom disorder can be difficult to diagnose as it is very possible that an individual is displaying early symptoms of a disease that cannot be detected or diagnosed yet. 

Other symptoms include gastrointestinal symptoms (e.g., nausea, diarrhoea), pain, neurological symptoms (e.g., dizziness), or any other symptoms afflicting other parts of the body.

What are some signs of Somatic Symptom Disorder? 

Many of us tend to worry when we experience some painful symptoms, and most of us have probably googled our symptoms out of curiosity and mild fear, right? (And no, despite what Google says, chances are that you are not dying) Having such concerns are quite normal as we obviously care about our well-being! However, people with somatic symptoms disorder are extremely preoccupied by their symptoms, and these concerns persist even when lab results and tests conclusively indicate that they are well. They may even avoid a wide range of activities out of the fear of exacerbating their symptoms, and in more extreme cases become isolated and inactive. In others, such concerns may become a core feature of their identity, which can be rather maladaptive. 

An individual with somatic symptom disorder also tends to experience the following: 

Ψ Significant and persistent concerns about one or more somatic symptoms which they find distressing
Ψ Disruption to their daily functioning due to the somatic symptoms
Ψ Spending excessive amounts of time and energy worrying about it and continuously seeking medical treatment
Ψ Persistent high levels of anxiety about their health or somatic symptoms 

What causes Somatic Symptom Disorder? 

While we still do not know the exact cause of it, cognitive factors are believed to play a strong role. Cognitive factors refer to our thoughts and beliefs. In this case, studies have found that people with the disorder tend to hold maladaptive and often incorrect beliefs about illnesses. For instance, they may be more likely to believe that serious illnesses are common, that any physical abnormality, no matter how minor, is a cause for great alarm, and that they are susceptible to many kinds of illnesses. People with Somatic Symptom Disorder also experience physical sensations more intensely and tend to engage in catastrophic thinking.

Intervention

Comprehensive intervention for people with somatic symptoms disorder includes pharmacological interventions and psychotherapy:  

Psychodynamic therapy:  

Psychodynamic therapy focuses on helping patients became aware of the links between their emotions and the physical symptoms they experience. This is achieved by helping them recall events and memories that may have triggered their symptoms 

Behavioural therapy:  

Reinforcement is another critical aspect of Somatic Symptom Disorder as it has been proposed that somatic complaints perpetuate because of reinforcement for their behaviour. To address this, the reinforcements for maladaptive behaviours are identified and eliminated. In its place, positive rewards for healthy behaviours are established. 

Cognitive therapy: 

As previously mentioned, people with somatic symptom disorder tend to engage in catastrophic thinking. To tackle this, cognitive therapy is used to help people learn to interpret their somatic symptoms in more appropriate and adaptive ways instead of catastrophizing.

Behavioural and cognitive therapy is usually practiced in combination as what is known as cognitive-behavioural therapy (CBT)!