“”I’M NOT MAKING THIS UP!”
Mental Health Institute Berlin
When physical complaints occur repeatedly or permanently, persist over a long period of time, and despite intensive diagnostics no organic causes can be identified that adequately explain the complaints, we speak of somatoform disorders.
Those affected have often gone a long way with extensive medical diagnostics. They are often confused, perplexed and frustrated because they can find no or only an inadequate explanation for the presence of the symptoms. The perplexity usually leads to further visits to the doctor, with the aim of finally finding a reason for the complaints. Sometimes those affected feel misunderstood and not taken seriously by the medical staff, since they are always told that they “have nothing”. The fact is that those affected suffer greatly and really “have something”. Their symptoms just need to be explained and treated differently than “purely physical”. They are not imaginary, but real, but arise in the central nervous system and not elsewhere. Therefore, it is essential to look in detail at the antecedents of the disorder with regard to stressful events.
How does a somatoform disorder develop? In scientific studies it could be determined that the so-called alexithymia (“blindness to feelings”) plays a decisive role. Alexithymic individuals have difficulty adequately perceiving feelings, distinguishing them, naming them, and expressing them. The hypothesis is that feelings are consequently expressed on a purely physical level. If stress factors meet a personal vulnerability, this can lead to the development of a somatoform disorder. Concrete causes are individually very different. Often there is a style of upbringing in the biography that did not allow any feelings in children (“An Indian knows no pain”), a violence-dominated style of upbringing to which children react with physical complaints instead of with fears, or a style of upbringing in which attention was only given when physical complaints were present. Traumatic experiences can also be causative.
Once the symptoms have developed, the physical complaints lead to a high level of suffering and often to considerable impairments in everyday life. As a reaction, those affected often develop short-term relieving illness behavior, which, however, in the long term leads to the reinforcement and maintenance of the symptomatology. Mentally, too, there is an increasing narrowing down to the symptoms. Those affected have the impression that they can no longer perform many activities or can only do so on “good days”. This, together with the feeling of despair and hopelessness, favors the development of depression and anxiety disorders, which often occur simultaneously.
somatoform Disorders include:
Typically, various, recurrent and frequently changing physical symptoms that persist for at least two years. The symptoms are varied, for example: Symptoms that suggest a neurological disorder (e.g., dizziness, balance disorders, numbness, tingling sensations, paralysis, difficulty swallowing, seeing double images, blindness, hearing disorders), gastrointestinal symptoms (e.g., gas, bloating, vomiting, diarrhea), or pain symptoms or functional impairment in various organ areas (e.g., head, chest, back, abdomen, rectum, joints, extremities).
Characterized by one or more physical complaints that persist for at least six months and result in significant limitations in various areas of life.
Characterized by a persistent fear or belief that one is suffering from a serious and progressive illness (e.g., cancer, multiple sclerosis). Physical complaints are then often interpreted as symptoms of this disease, leading to massive anxiety. To reduce this anxiety, sufferers tend to self-examine and make frequent visits to the doctor (“doctor (s)hopping”) to make sure everything is okay.
The sufferer describes symptoms that he or she attributes to a physical disorder of a system or organ that is autonomically innervated, e.g., the cardiovascular, gastrointestinal, respiratory, or urogenital systems. At the same time, there are symptoms of autonomic stimulation (e.g., palpitations, sweating, flushing, trembling) and subjective, nonspecific, alternating complaints (e.g., burning sensation, heaviness, tightness) that are not indicative of disease of the system in question but are attributed by the affected person to a specific organ or system.
Typically, there is chronic pain lasting at least six months, the origin of which is not clear. In addition, there is excessive preoccupation with pain and considerable distress.
How are somatoform disorders treated at MHI Berlin?
The basis for a goal-oriented treatment of somatoform disorder is first of all a careful diagnosis with the collection of the individual medical history and a detailed examination of the previous findings. If the diagnosis of a somatoform disorder is made, there are various psychotherapeutic building blocks that are goal-oriented.
On the one hand, a psychosomatic explanatory model for the development and maintenance of the complaints is developed. Together with the patient, we look for possible psychological causes that contribute to the maintenance of the symptoms. If there is a tendency to avoid, check or doctor-hop, this is gradually reduced. If there are difficulties in perceiving and expressing feelings, the goal is to develop an adequate emotional life. The training of social skills, in particular social conflict resolution strategies and problem solving strategies, is also to be promoted in order to be able to deal better with critical situations in the future.
The MHI Berlin offers its services to patients of all private health insurances, as well as to those paying for their own treatment. Immediate admission to the day clinic is usually possible.