Thoughts on Somatoform Disorder... and a Lot of Questions!

1. Somatoform disorder is the name for a group of conditions in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can't be traced to a specific physical cause. In people who have a somatoform disorder, medical test results are either normal or don't explain the person's symptoms. This group of disorders includes: Conversion disorder, Dissociative disorder, Somatization disorder, Hypochondriasis, Factitious disorder, and Body Dysmorphic Disorder.


I will admit that after reading my texts twice- I am still not sure that I 'get' Somatoform disorder. Or at least I thought that I was starting to get it until I read a lot of the other posts from my other classmates. Everyone seemed to focus on hypochondriacs and while I do think that was part of being discussed... well, I guess I wasn't really convinced that was the whole idea... And the amount of backbiting/rudeness and judgement was quite impressive ('I know someone just like that and she does it for the attention...' or 'I know someone who definitely fits this disorder and they go to the doctor all the time but it's clear there's nothing wrong with them', etc...)

Am I wrong? Maybe I am so focused on the idea that I was so sick and nobody could find anything wrong for a year. I had x-rays, ultra sounds, a colonoscopy or two, and was poked and prodded by everyone imaginable in my local practice and was given huge antibiotic shots every few weeks, started Prozac and was then sent to a third specialist... who then gave me an upper-endoscopy and then told me that all of my symptoms made perfect sense for the problem that I was really having... which wasn't recognized by any of the other physicians that I had seen.... So how can you really be sure that someone is a hypochondriac and doesn't really have something physical wrong with them? Especially just by casual looking or conversation...? The textbook talked about how women are more likely to be diagnosed with this disorder... can this be because physicians as a rule are more likely to think women have something wrong with their mind (anxiety, etc) than a heart attack for instance... and so they do not look deep enough? Or am I just overly tolerant and not cynical enough?

I guess I also wonder if pain disorders have to be specifically 'pointed' at in the sense that I think that Fibromyalgia is a 'pain disorder' but there doesn't seem to be anything specific to 'point' at- they hurt, but no one seems to know for sure why? Are they hurting?... I have no doubt. Is it all in their mind? I can't believe that... Also if I look at the criteria, is it possible that someone with a bad relationship and stress problem be able to be 'diagnosed' with this disorder that with time and other changes could no longer qualify for this disorder? For instance, if my friend Pamela has belly pain and reflux from stress (she thinks), a sex symptom- because she has no interest in sex with her estranged husband right now, and she is also likely to complain of random chest pain, a twitching eye, headaches, and leg pain... could she be diagnosed with this disorder if her doctor can't find anything definitive? Even though a casual discussion and exam could probably show that this is most likely temporary and stress related? And once you are diagnosed, can you ever 'lose' the diagnostic label... or is it yours forever? I also wonder which came first- the label hypochondriac or somatoform disorder... although I suspect that the term hypochondriac came first. I guess I have more questions this week than answers- sorry :(

One thing that was really interesting to me was that Body Dsymorphic Disorder is one of the disorders under this diagnosis- known to us lay people usually as anorexia or bulemia. Because maybe that is my clue for understanding the idea of the disorder. If the idea behind BDD is than an individual for some reason is unable to accept who he/she is or what he/she looks like or can't be what he/she wants to be... is able to for unknown reasons in her mind attempt to force the body into what he/she cannot have (and I believe that is done unconsciously truly- I can't imagine that those thought processes are something that someone works on to develop... although I could be wrong.) Well, than maybe what the book is trying to say is that a person has so much 'stuff' in his/her life that is painful (whether it is abuse, stress, etc...) that they cannot control... then the unconscious mind tries to get out some of the strain through other various ways which the individual doesn't tend to recognize and then they go to the doctor thinking that they had another problem. But I guess I am again stuck on the idea that at some point the doctor can decide that the patient has nothing really wrong and diagnose them with this when it could be something else.

Does anyone out there know someone who has one of these disorders and can maybe give me a little more insight into it? I really am curious and want to have a real discussion on it. What do you think if you are someone who has it? Would you be willing to explain a little bit of your personal history so maybe I can understand a little better?