Posted by Adam on July 13, 2001, at 21:12:19
In reply to I may need help...., posted by Adam on July 13, 2001, at 7:14:58
Just grabbed my handy-dandy Stedmans...
somatization: The process by which psychological needs are expressed in physical symptoms; e.g., the expression or conversion into physical symptoms of anxiety, or a wish for material gain associated with a legal action following and (sic) injury, or a related psychological need. SEE ALSO somatization disorder.
Well, here's an interesting hypothesis...
"The patient complains of strange physical symptoms including but not limited to fatigue; hot and cold flashes; flushing; arthritic pain, mostly in lower extremities; occasional tachycardia; sensation of superficial "pressure" in face, upper neck reminiscent of sinus congestion. Patient displays anxiety, describing symptoms as "bizarre". Patient shows tendancy to self-diagnose, coupling relatively high medical literacy with vivid imagination.
Patient history reveals dual-diagnosis of major depressive disorder and somatic obsession, including hypersensitivity to percieved flaws in facial features, as well as another "acute" homophobic sexual obsession. Patient currently on antidepressant therapy (MAOI, selegiline hydrochloride, 15mg b.i.d.), and has undergone behavioral therapy for obsessive-compulsive disorder. Patient responded well to both treatments. Patient has prior history of hospitalization for depression, as well as electroconvulsive therapy. Patient describes traumatic childhood, having lost maternal parent to cancer at age 7-8, and having suffered physical and emotional abuse from paternal parent.
Patient describes recent period of emotional stress related to a camping trip, where patient developed a romantic interest in another participant. Patient anxiety over this experience relates to conflicted feelings due to current, long-term monogamous relationship with another woman. Patient describes current relationship as stable and satisfying, and has not persued the other party as a paramour.
The patient claims first hints of physical symptoms occurred during camping trip, where he met the woman he became infatuated with. Patient reveals he asked her to drive his car home with him, due to feelings of dizzyness and fatigue.
Concurrence of onset of physical symptoms and the distressing romantic encounter point to possible somatization related to conflict surrounding "inappropriate" sexual interest in another woman, coupled with fears of said threat to current amorous relationship. Patient history of loss of parent and prolonged parental abuse predisposes for feelings of excessive guilt, difficulty with intimacy, and fears of abandonment, which may be manifested in aberrant behavior, possibly to precipitate conflict and relive childhood traumas. Physical symptoms are likely manifestation of schema where patient seeks superficial reassurance and/or sympathy from surrogate parent-figure only to experience distress related to fears or anticipation of loss."
Yes, it seems be a good theory except for the fact that it is complete horseshit. I don't think my hypothtical "diagnosis" is that implausible, so far as I might be likely to encounter it, should all be revealed to my health care providers. The comedy of it would be no one would guess that such a thing would have occured to me, the patient, already. Even if it reached the point of discussion, and I discounted it, well, that's denial, right? I might need a fair amount of convincing, maybe even months of therapy if my symptoms persisted. Any sequellae following acute signs of imagined infection would simply be more somatizations, and product of a mind familiar with the progression of Lyme disease. I dreampt it all up. After all, I have a psychiatric disorder. I'm mentally ill. Inexplicable physical symptoms are not what they seem. It's obvious, elementary.
I guess this is the kind of thing I have to be aware of myself to avoid diagnostic abuse. Gee do I sound paranoid, am I convinced of vitimization? Oh, more fertile psychodynamic ground to explore. The possiblities are as endless as the diagnosticians imagination, and as subjective as a Rorschach test.
poster:Adam
thread:69963
URL: http://www.dr-bob.org/babble/20010708/msgs/70058.html