- 0:44 Somatoform Disorders
- 1:20 Conversion Disorder
- 2:30 Dissociative Disorder
- 3:47 Pain Disorder
- 4:20 Hypochondriasis
What's the mind's relationship with the body? In this lesson we'll examine how some physical symptoms could actually be caused by psychological factors.
Psychology is full of examples of how mind and body are connected. Many psychological disorders produce negative bodily symptoms; Jim's depression gives him unexplained body aches, while Karen's panic disorder produces respiratory symptoms during attacks. You've probably experienced something like this; maybe anxiety gives you a stomachache, or feeling sad makes your head hurt.
Somatoform disorders take this idea of 'mind over matter' to a whole new level. Patients experience symptoms severe enough to often be mistaken for other physical disorders; for example, severe pain, or even paralysis. But these symptoms have entirely psychological causes. This isn't the same thing as faking symptoms, or malingering; patients with somatoform disorder really believe they're sick, and often frightened by the symptoms they experience.
First let's take a look at conversion disorder, a somatoform disorder with symptoms that at first seem neurological; weakness or paralysis of part of the body, impaired speech, seizures, tremor and difficulty walking. It would be pretty scary to experience any of those symptoms; patients and doctors alike often think that they're dealing with something really dangerous like a stroke. In order to diagnose conversion disorder, doctors must eliminate conditions like stroke, multiple sclerosis (MS) and epilepsy. As these more common causes of symptoms are eliminated, a psychological explanation becomes more and more likely.
But how - and why - does a patient's mind do this to the body? Freud thought that the body 'converted' (hence the name) anxiety into physical symptoms which were described at the time as 'hysteria.' Typical of Freud, these anxieties were thought to come from repressed memories or desires, those things that we actively try not to think about. Modern psychologists think it's more likely to be a kind of dissociative disorder, or a condition in which the mind splits itself into more than one piece. In cases of paralysis due to conversion disorder, these psychologists think that the mind basically 'ignores' the part of itself that deals with the affected limb, leading to lack of sensation. We'll talk more about dissociative disorders in another module, but it may help to know that the phenomenon of 'split personalities' is categorized as one as well; in that condition, the mind is able to segregate itself into two (or more) distinct and complete personalities. So while strange, perhaps it seems a little more plausible that the mind is also able to segregate itself from a hand or a foot.
'Conversion disorder' has a variety of potential symptoms; some patients, however, simply experience pain. Pain disorder is another somatoform condition characterized by debilitating pain that does not have a physical cause. Many of these patients have just experienced real pain from an accident or illness, but the pain either never subsides or returns even after the underlying cause has been dealt with. Normal, physical pain is caused by nerve signals that the brain has to process. Because of this, pain is actually always created in the brain - therefore it is possible for the brain to create pain without physical trauma.
There's one last somatoform disorder that's a little different than the ones we've talked about: hypochondriasis. Have you ever felt a strange pain somewhere, maybe in your foot, and gone on the Internet to Google your symptom? Or maybe you go straight to WebMD and use their 'symptom checker' body map? As the results start pouring in, you find that your foot pain could be a symptom of scary-sounding 'peripheral neuropathy,' which another quick Google search confirms is indeed scary: it means you have damage to your peripheral nervous system. Completely ignoring the other potential diagnosis of 'poorly fitting shoes,' you decide that you're definitely dying and call up your doctor's office to make an appointment.
By assuming the worst about a mild symptom, you exhibited mild hypochondriacal behavior; people with hypochondriasis worry that any symptom they experience signals the presence of serious illness. Some seek medical assistance constantly; others try to avoid any reminder of illness, and are afraid of hospitals and doctors. Most are distrustful of doctors' diagnoses, convinced that the physician is misinterpreting their symptoms. They typically experience intrusive thoughts about their symptoms - imagine if with your foot pain, you would think about it at inappropriate and distracting times, like during an interview or while doing homework. In this way they are similar to people with obsessive compulsive disorder, though those with OCD are typically more concerned about catching and spreading disease than they are about actually being sick.
We've looked at several somatoform disorders, which are characterized by the brain's production or misinterpretation of real physical symptoms. Conversion disorder was primarily neurological; pain disorder was - BIG SURPRISE - when patients felt pain without physical cause; and finally, hypochondriasis was what happens to you when you Google your symptoms - you think every ache and pain means you have cancer.
Chapters in Psychology 101: Intro to Psychology
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