New research on somatization disorder

Submitted by Jason Luoma on August 24, 2006 - 5:20pm
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Here's an excerpt from a NY Times article on research on somatization disorder that's kinda cool. Some very ACTy sounding stuff. Thanks to Mary Politi for originally posting this article on the ACT listserv.

for the full article see: http://www.nytimes.com/2006/08/22/health/22symp.html?ex=1156478400&en=ed906844e55c23fe&ei=5070

Doctors Give Hope to Patients With Long Histories of Unexplained Symptoms By DAN HURLEY

Two new studies by researchers who specialize in the baffling
condition called somatization syndrome, estimated to affect up to 3
percent of adults, suggest that the quest for a physical explanation
may take on a destructive life of its own. Instead, those with the
syndrome should focus on practical strategies to regain normal
function and relieve symptoms, the researchers say.

One study, by German scientists, sought to explain why the doctors'
reassurances were generally ineffective with such patients. The
researchers played taped comments by a doctor about a hypothetical
patient for two groups of participants, people who had the syndrome
and people who did not. Those with somatization syndrome were three
times as likely to believe incorrectly that in the course of the
comments the doctor had said the symptom had a worrisome physical
cause.

The findings, in the August issue of the online journal Public
Library of Science Medicine, offer at least a partial explanation
for why patients often go from doctor to doctor and take test after
test in a fruitless search for answers: repeated reassurances are
simply not being understood.

A second study, by New Jersey researchers, provides the first
published evidence of an effective clinical treatment. The study, in
the July 24 issue of The Archives of Internal Medicine, found that
patients benefited from 10 sessions of cognitive behavioral therapy
specifically organized to help relieve their stress and increase
emotional awareness and to get them to become more socially active
and think differently about their symptoms.

"They stop their dance classes and don't go to work and don't spend
as much time throwing the ball with their kids," Dr. Allen
said. "Our treatment emphasizes changing their behaviors, trying to
change the focus of their lives from worrying about their symptoms
to re-engaging in activities they've been avoiding."

The 84-patient study, compared the behavior therapy with the
standard treatment.

Comments

Cultural definitions of "somatization"

Submitted by Randy Burgess on August 25, 2006 - 9:24am.

I have read that the lifetime prevalence of this disorder may be as low as 0.2% in men and 0.2% to 2% in women. Higher figures may result from more liberal definitions.

In any case there is a much larger population with stress-related disorders such as fibromyalgia, chronic fatigue, adrenal exhaustion, etc. In the U.S., this population is caught between the Scylla and Charybdis of a mechanistic, drug-oriented, psychologically obtuse medical culture, on the one hand, and an alternative medical culture which seems nearly as helpless and which too often validates victimhood. ACT can help with psychological relief and behavioral improvement - but these larger frameworks deserve to be questioned as well.

The other thing that comes to mind in terms of the prevalent medical "story" in this country is an excerpt from "Buddhist Practice on Western Ground," a book by the psychotherapist Harvey B. Aronson on the value of therapy for Western practitioners of Buddhism. Aronson quotes this excerpt in his chapter on anger; the original source is also the New York Times - a column by Dr. Anna Fels from 2002 dealing with how physicians in this country are only slowly catching on to the mind-body connection:

A fellow psychiatrist once told me an anecdote I have never forgotten. He was at a conference about depression in developing countries. The essence of the lectures was that people in those areas commonly expressed depression as physical symptoms. They ''somaticize'' their depression, to use the medical parlance, complaining of malaise, stomachaches, dizziness and other symptoms that are hard to pin down.

Techniques were discussed for dealing with the patient who insists her only problem is a heavy head or a squeezing sensation in the belly, but who is clearly depressed.

Toward the end of the meeting, a doctor from India stood to speak. ''Distinguished colleagues,'' he said, ''have you ever considered the possibility that it is not that we in the third world somaticize depression, but rather that you in the developed world psychologize it?''

His comment, my colleague reported, was met with stunned silence.

What a beatiful story

Submitted by Jason Luoma on August 25, 2006 - 10:19am.

That's a beautiful story. A wonderful example of the contextual basis of "truth." I hope it gets used in presentations. Thanks for taking the time to share it with all of us.
Jason Luoma
www.drluoma.com