This paper addresses the use of cognitive behavioral therapy (“CBT”) to treat somatoform disorders and analyzes CBT both in general and how it compares to other treatments for the same disorder. Given the somewhat limited analysis of this treatment area by medical and mental health professionals, and as a result of the relatively recent nature of the analysis that does exist, various recommendations are discussed with respect to improvement of the existing treatment methodology.
Somatoform Disorders
The Diagnostic and Statistical Manuel of Mental Disorders, Fifth Edition (DSM-V), describes somatoform disorders as a group of related mental health symptoms that are characterized by a patient’s presentation of multiple, current somatic symptoms that are distressing or result in significant impairment of daily functioning. A somatic symptom is the presentation of physical illness or distress that would appear to have a medical basis but which cannot be explained by either a general medical condition, direct effect of a substance, or any other mental health disorder. Patients who suffer from somatoform disorders firmly believe that the pain they are experiencing stems from a physical problem rather than a mental one; indeed, that is a fundamental aspect of the disorder. Somatoform disorders range from a simple and persistent pain disorder to hypochondriasis, which involves persistent anxiety over the existence of a serious illness, to conversion disorder, which involves the actual loss of a bodily function from excessive anxiety over the perceived ailment. (DSM-V, 2013)
The nature of the disorder makes it difficult to treat, since patients are convinced that they suffer from a real and serious medical problem. Indeed, the mere su...
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...has evidenced a greater likelihood to be more efficacious in the overall treatment of the disorder. While some other treatments have been shown to have positive results in certain circumstances, through multiple studies it has been preliminarily determined that only CBT remained consistently effective in reducing patients maladaptive symptoms and behaviors, and was the only treatment option that consistently improved functioning over a long period of time, further offering support for CBT as an empirically supported treatment for somatoform disorders. Nevertheless, substantial additional research and work is needed in order to better understand the various forms of the disorder and how to best address and treat each of them individually. With the expansion of research on somatoform disorders and what causes these disorders, treatment will be expanded and improved.
A physician has an unenviable position; he is closest to man approaching a god-like stature. And despite the demise of 'doctor knows best', we still need to trust his diagnosis-something that is increasingly difficult in a world where information is widely available, and Google substitutes for a doctor. In the case of psychiatry the issue of trust is amplified since diagnosis is based on a patient's expressed thoughts and overt behaviours rather than solely on biological phenomena. And these thoughts and behaviours are influenced by the patient's environment-a mix of his social, cultural and technological experiences.
Biological theorists, have very little to say since there seems to be no physical cause of the symptoms, except that there may be some genetic predisposition to Somatoform disorders.
CBT has been known to cure a variety of disorders both in clinical environments and non-clinical environments. This type of therapy technique has been tested for efficacy and has proven to be highly effective. Furthermore, the future for CBT looks very positive as well. Researchers and theorist are now working on making this type of therapy available for suicide prevention, schizophrenia, and other psychopathologies.
The disorder which is being treated is actually strengthened to the point of a serious mental illness. Similarly, in today’s society, medical and psychological advice may have the same effect. Medical technology and practice have progressed considerably since the time of the “Yellow Wallpaper.” This is not to say that today’s physicians are infallible. Perhaps some of today’s treatments are the “Yellow Wallpaper” of the future.
Paula’s profile is indicative of someone who is experiencing marked distress and impairment in functioning (ARD, DEP, SOM, BOR, and SCZ). Her profile suggest that there may be issues of anxiety related disorders and depression that are chronic and long-standing (BOR-N, BOR-I). This profile is common in people who are detail oriented, rigid in their attitudes and behaviors, conforming and ruminating (ARD-O). This profile pattern also reveals symptoms of a person with high anxiety and tension that may seem rigid and inflexible (ARD). Her profile further indicates an individual who attempts to control her emotions using maladaptive behavior strategies (ARD, ARD-0) to create order and predictability.
Schildkrout, Barbara. “Unmasking Psychological Symptoms: How Therapists Can Learn To Recognize The Psychological Presentation Of Medical Disorders”. n.p.: Hoboken, N.J. : John Wiley & Sons, c2011., 2011. USMAI Catalog. Web. 12 Nov. 2013.
(Sadock & Sadock, 2008) In recent years, however, the viewpoint has become less doubtful or constrained in planning effective treatment. The goals of treatment are to establish the diagnosis, decide on suitable interventions, and manage difficulties. (Sadock & Sadock, 2008) The success of these goals depends on an effective and therapeutic doctor–patient relationship, which is initially, not easy to create. The patients do not complain about psychiatric symptoms and often enter treatment against their will; even the psychiatrist may be drawn into their delusional nets. (Sadock & Sadock,
452). A person of any age group can been treated successfully with CBT. Many mental health disorders are caused by and attributed to internal and external factors: biological, psychological, and sociologically. According to Farmer and Chapman (2008), they discuss how “CBT is a broad concept and represents a variety of therapeutic approaches that emphasize, to varying degrees, cognitive, behavioral, and environmental factors in relation to psychological disorders” (p. 3). CBT has been readily used in addictions and Couples/Family therapy as CBT can treat interrelationship issues caused by addictive behaviors as well as couples or family
Effective psychotherapy treatment for this disorder is imperfect. It is likely, though, that intensive, psychoanalytic methods are inappropriate for this population. Approaches that reinforce appropriate behaviors and endeavoring to make connections between the person’s actions and their feelings may be more constructive. Emotions are regularly a key facet of treatment of this disorder. Patients often have had little or no substantial emotionally-rewarding relationships in their lives. The therapeutic relationship, consequently, can be one of the first ones. This can be very scary for the client, initially, and it may become insufferable. A close therapeutic relationship can only happen when a good and solid relationship has been time-honored with the client and he or she can trust the therapist subliminally.
With this disorder it is important to build a positive relationship with the client. It’ll be important to use patience as the client may struggle to trust the therapist which may affect the direction of treatment. Also when working with the client, I may suggest medication therapy if they desire. I feel that this disorder is treatable and that with the approaches most clients will experience improvement.
Halgin, R. P., & Whitbourne, S. K. (2010). Abnormal psychology: clinical perspectives on psychological disorders (6th ed.). Boston: McGraw-Hill Higher Education.
To create a treatment plan for a disorder, you have to first diagnose the disorder that the client has. My client in this scenario has an obsessive compulsive disorder, otherwise known as OCD. One of the ways to treat OCD is through Cognitive-Behavioral Therapy, or CBT. CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. It is based on the concept that your thoughts, feelings, and actions are all connected. It says that your negative thoughts and feelings can get you into a cycle of these types of feelings and thoughts. CBT helps you deal with your problems by breaking them into smaller parts. It helps you improve the state of mind that you have. Instead of focusing on your past, it focuses on the problems that you have currently.
One could say it is the transference of a person mental anguish into physical issues. Individuals with somatization disorder may complain about their symptoms in a very dramatic way, yet describe the symptoms in very vague or unclear terms. They may also visit more than one doctor for diagnosis and treatment for the same symptoms, have test results that do not confirm any medical illness to explain their symptoms. A person with somatization disorder is not intentionally producing or pretending to experience these physical complaints. You should have at least one reference in this
Barlow, D., Durand, V., & Stewart, S. (2009). Abnormal psychology an integrative apporach. (2nd ed.). United States of America: Wadsworth
The last category of somatoform disorder being discussed, and possibly the complex form of this disorder, is conversion disorder. Many case studies have been published speaking to the conceivable severity of this disorder. A conversion disorder is defined as, A disorder involving the loss or alteration of physical functioning, such as paralysis, voice loss, tunnel vision, or seizures, that is the result of a psychological involvement or need rather than a physical illness or disease. Also called conversion hysteria, conversion hysteria neurosis, conversion reaction (Stedman's Medical Dictionary, 2006). While there are many symptoms that are associated with conversion disorder, the most common reported are loss of sight,