Interdisciplinary Considerations in the Psychotherapy of Psychosomatic Patients

Abstract

Patients with psychosomatic conditions, who comprise a significant proportion of students seeking health care, demonstrate clearly the need for effective functioning of the health care team. These patients usually present themselves with problems of physical illness for practical, social, and psychodynamic reasons. Socially they seek to avoid the stigma attached to acknowledging psychological problems. Psychodynamically, such patients have transformed psychological problems into physical illness and need help in reversing this transformation. Attending only the physical illness or dismissing the patient because “it's all in your head” are inappropriate responses deeply embedded in popular culture. Case illustrations are used to show the need for careful diagnosis from physical and psychological standpoints, for skillful referral and interdisciplinary collaboration, and to show how psychotherapy can reverse the psychosomatic process and the underlying psychological determinants. The illustrations include cases of headache, asthma, ulcers, and disturbances of sleep and appetite. Both specific psychotherapeutic technique and overall theory are discussed.