Many psychologists see clients who are worried about physical symptoms with no clear medical explanation, whether they are headaches, abdominal pain, chronic fatigue, irritable bowel, fibromyalgia, chemical sensitivities, or unexplained body pain. It turns out that medically unexplained symptoms (MUS) are actually quite common; studies show that at least a third of somatic symptoms presented in the primary care fall into this category, according to Kurt Kroenke, MD. Physicians often see symptoms without a definitive organic cause as “psychosomatic”—the interaction of mind and body.
While there are plenty of unanswered questions about the cause and nature of mysterious physical ailments, there is no question that these patients suffer as or more than those whose illnesses have concrete organic labels. It is often more challenging for individuals with psychosomatic complaints due to the uncertainty and social stigma attached to their condition. Individuals can become distraught not knowing the cause or suggested treatment for their illness. Further, they also have to contend with society’s view that because they lack a diagnosis or known cause, they’re not really sick. These patients can also inadvertently get overly entangled in the medical system because physicians often don’t know how to refer them to the right mental health professionals.
Researchers studying the psychological aspects of medical illness are providing a better understanding and integration of conditions that may have both physical and psychological components. Viewing illnesses along a mind-body continuum is becoming more popular than the previous either-or understanding. This thinking is reflected in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which included a category called Somatic Symptom Disorder for people with severe, chronic and troublesome physical symptoms that may or may not have a medical explanation.
Thanks to growing knowledge of the complex ways the brain affects the body, practitioners and researchers are developing more nuanced ways of treating such patients. Some are tailoring cognitive behavioral strategies specifically to address physical symptoms, while others are creating evaluation models that understand unexplained conditions in terms of various biopsychosocial factors.
Research has revealed that interventions tailored to treat psychosomatic complaints are indeed effective. For instance, Robert Woolfolk, PhD, showed that fibromyalgia patients who received a form of cognitive behavioral therapy reported less pain and overall better functioning than those who received only usual care. Further, another study by Susan Gaylord, PhD, found that female patients with irritable bowel syndrome randomly assigned to eight weeks of mindfulness-based therapy had greater reductions in physical symptoms than those assigned to a support group. They also reported higher quality of life and lower distress and anxiety than support-group members.