Mark Hillman, Ph.D., (PSY) LMHC My Therapist is Making Me Nuts!Written by Mark Hillman

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Somatoform Disorder

The most common characteristic of the somatoform disorder is the appearance of physical symptoms or complaints of such without any organic basis. Such dysfunctional symptoms tend to range from a specialized sensory or motor disability to hypersensitivity to pain.

Four major somatoform disorders exist: conversion disorder (also known as hysteria), hypochondriasis, somatization disorder, and somatoform pain disorder.


Conversion Disorder

Primary symptom is often a lack or change in physical functioning. The diseased often react with an attitude of indifference, showing an amazing lack of concern. However, the primary symptoms which may include such serious ailments as blindness, amnesia and paralysis, are used as a defense mechanism by the person to escape from a stressful situation. In addition, there may be an awareness of the gains possible through the use of the symptom, which may prolong the symptom. Symptoms are grouped as follows:

Sensory Symptoms: These include anesthesia, excessive sensitivity to strong simulation (hyperesthesia), loss of sense of pain (analgesia), and unusual symptoms such as tingling or crawling sensations.

Motor Symptoms: In motor symptoms, any of the body's muscle groups may be involved: arms, legs, vocal chords. Included are tremors, tics (involuntary twitches), and disorganized mobility or paralysis.

Visceral Symptoms: Examples are trouble swallowing, frequent belching, spells of coughing or vomiting, all carried to an uncommon extreme.


Unlike conversion disorder where an individual perceives a functional disorder and simply uses it to escape from uncomfortable situations, hypochondriacs have no real illness, but are obsessed over normal bodily functions. They read into the sensations of these normal bodily functions the presence of a feared disease.

Symptoms: The afflicted magnifies small irregularities in bodily functions, real or imagined, and then expresses concerns over their general health. Focus may lie on a changing area of the bodily system or be specific, such as a certain believed lung condition. Usually, the individual seeks opinions of many physicians and takes pleasure in criticizing their methodology when they are diagnosed as perfectly healthy.

Somatization Disorder

People with somatization disorder have multiple complaints over many years, involving several different regions of the body. For example, the same person might complain of back pain, headaches, chest discomfort, and gastrointestinal or urinary distress. Sexual complaints are common, such as irregular menstruation in women or erectile dysfunction in men.

The person may:

    Describe symptoms in dramatic and emotional terms
    Seek care from more than one physician concurrently
    Describe symptoms in vague terms
    Lack specific signs of medical illness
    Have complaints that laboratory investigations (such as blood tests and X-rays) fail to support

Somatoform Pain Disorder

Somatoform Pain Disorder, also called Pain Disorder, is persistent and chronic pain at one or more sites in which psychological factors are thought to play a role. Pain is one of the most common reasons that people seek medical attention. In pain disorder, the suffering is so severe that it impairs a person's ability to function. Furthermore, the pain itself is thought to be related to psychological factors, such as stress or unconscious conflict. Individuals with this illness may have other medical problems, though these fail to account fully for the pain.


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