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 the mind and the body are connected. Maybe you’ve experienced this for yourself.
Maybe you’ve gotten a headache because you were worrying about completing an important assignment, or a stomach ache before a job interview. These aches and pains pass, once the thing that’s stressing you out or upsetting you, has also passed. Many psychological disorders produce negative bodily symptoms.
For example, depression might give you unexplained body aches, while panic disorder, might actually produce some respiratory symptoms during panic attacks.
Now somatoform disorders take this whole 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. There are some patients who come into the hospital unable to move a leg or an arm and are convinced they are suffering from a severe physical disease. 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 are often frightened by the symptoms they experience.
First let’s take a look at conversion disorder, which is a somatoform disorder with symptoms that at first seem neurological; you might have weakness or paralysis of part of the body, impaired speech, seizures, tremor and difficulty walking. Now imagine you are experiencing any of these symptoms, you’d probably get yourself straight to the hospital. Now imagine that once you got there, a doctor told you that these symptoms were essentially all in your head. Conversion disorder can be really difficult to diagnose and treat because patients and doctors alike have a hard time fully committing to the idea that such severe symptoms can be caused by the brain alone. In order to diagnose conversion disorder, doctors must eliminate conditions like stroke, multiple sclerosis (MS) and epilepsy. And as these more common causes of these 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.
Now 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. Now most people don’t have experience dissociating their minds, but it’s a little like being bilingual; just like your mind makes a switch between one language and another, your mind can also theoretically make a switch between one segment and another.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.
Now try to imagine what this would be like. It would be like that limb, say it’s your arm, were no longer a part of you. Now we’ll talk a little more about dissociative disorders in another lesson, 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. Imagine again that you’re bilingual, and then extend that to having a completely different personality with each language.
So while it might seem strange that your mind could basically forget it’s arm, it might seem a little more plausible when you think about the fact that it can theoretically also have two totally different personalities in the same head.
But some patients with somatoform disorders simply experience pain. This is called Pain disorder and it’s 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 really 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 any physical trauma.
Now there’s one last somatoform disorder that’s a little different than the ones we’ve talked about: hypochondriasis. Now 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 little ‘symptom checker’ body map? As the results start pouring in, you find that your foot pain could be a symptom of a scary-sounding disease called ‘peripheral neuropathy,’ which another quick Google search confirms is indeed very 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 acted like a hypochondriac. 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 any physical cause; and finally, hypochondriasis was what happens to you when you Google your symptoms – you think every ache and pain means that you have cancer.