Bodily Harm: Recognizing and Treating Somatoform Disorders

In Western culture, the mind and body are often thought of as discrete entities that happen to occupy the same physical housing unit. But our psychological and somatic selves are in fact intimately connected and have a complex, reciprocal relationship that many of us only become aware of in short bursts, such as the nausea that arises before a public speaking engagement or the trembling that may accompany great fear. However, for some, physical expressions of psychological states are more than normal, momentary blips, and become enduring, debilitating somatic symptoms or preoccupations with no underlying physiological cause. Referred to as Somatoform Disorders, this phenomena can manifest in a variety of physical and psychological experiences that interfere with your quality of life and ability to function. In contrast to Factitious Disorders, people with Somatoform Disorders are not faking symptoms, but experiencing very real physical and emotional distress that requires specialized mental health interventions.

Somatoform Disorder is not a specific diagnosis, but an umbrella term for a number of mental health disorders:

• Conversion Disorder. Conversion disorder is a mental health condition in which you experience a loss or alteration of bodily functioning due to overwhelming psychological distress, and without a physiological reason. Your physical symptoms may be movement or sensory-based, and often include paralysis, difficulty swallowing, seizures, numbness, blindness, or hearing difficulties. While some conversion disorder symptoms may be random, others experience highly specific functional losses as the result of particular traumas.
• Pain Disorder. People with pain disorder experience clinically significant physical pain in one or more parts of the body that causes significant distress or functional impairment and has no physiological cause. Often, pain disorder arises from a period of extreme psychological stress or traumatic event and typically manifests as headaches, stomach pains, or back pain.
• Undifferentiated Somatic Symptom Disorder. Undifferentiated somatic symptom disorder occurs when you experience one or more physical symptoms that do not have an underlying physical cause and do not fit into another somatic disorder category for a period of more than six months. People with this type of mental health disorder may experience a wide variety of symptoms, including gastrointestinal problems, fatigue, pain, and appetite loss, and physical complaints may multiply or change over time.
• Illness Anxiety Disorder. People with illness anxiety disorder, formerly known as hypochondriasis, experience an intense preoccupation with getting or having an illness. You may see normal bodily functions and minor discomforts such as headaches as cause for major concern, and this anxiety persists despite medical exams and tests indicating that you are healthy. You may avoid certain places, people, or activities for fear of potential health hazardous and spend a substantial amount of time researching possible illnesses online.
• Body Dysmorphic Disorder. Body dysmorphic disorder involves an overwhelming obsession and dissatisfaction with your physical appearance. You experience great distress over your perceived physical flaws, and may compulsively examine yourself in mirrors, spend excessive time grooming, and take drastic measures to correct the features you regard as unbecoming, including cosmetic surgery and dangerous diet or exercise regimes. Many people with BDD are convinced that they are too unsightly to be seen in public and avoid participating in normal activities to avoid being looked at by other people. In some cases, you may be unable to work or even see family and friends due to extreme self-consciousness.