Why Behavioral Medicine May be a Good Fit for a Condition Diagnosed as Psychosomatic

hands together in deep thought

The Division of Health Care Between Mind and Body

In modern or conventional medicine, ‘Western’ scientific thinking has led to a deep division between the mind and the body. That is why America and many other countries have distinct mental health and physical health professions. This division of care often leads to incomplete or poorly integrated treatment that neglects either the mind or the body.

Counselors and therapists are highly skilled at addressing the mental aspects of many conditions but have few tools to address the physical conditions that affect the mind. On the contrary, syndromes and disorders which cannot be seen on an X-ray, scan, or lab result, are often taken less seriously by Medical Doctors. Individuals with these conditions may feel stigmatized by the health care system.

As a result, serious conditions are often underdiagnosed and undertreated, such as:

  • Fibromyalgia
  • Chronic fatigue syndrome (ME/CFS)
  • Multiple Chemical Sensitivity Syndrome
  • Endometriosis
  • Chronic Epstein-Barr
  • Lyme Disease
  • IBS
  • Migraines
  • Chronic pain syndromes
  • Dysmenorrhea (painful or difficult periods)

Some of patients with these conditions may be dismissed as being psychosomatic or even face hostility when pursuing treatment. This has become so common that the term psychosomatic has come to erroneously mean fake, made up, or “all in your head” for most people.

 

Behavioral Medicine Treats the Whole Person

The field of behavioral medicine reintegrates the mind and body based on research from the fields of mental and physical health. A study published in the International Journal of Behavioral Medicine defines the field as:

characterized by the collaboration among multiple disciplines concerned with the development and integration of biomedical and behavioral knowledge relevant to health and disease, and the application of this knowledge to prevention, health promotion, diagnosis, treatment, rehabilitation, and care. The scope of behavioral medicine extends from bio-behavioral mechanisms (i.e. the interaction among biomedical, psychological, social, societal, cultural and environmental processes related to health and disease), to clinical diagnosis and intervention, and to public health.”

In other words, behavioral medicine seeks to treat each person as a “whole person” composed of a mind and body which are part of and impacted by broader environmental and social systems. When looking through this lens, conditions which contain both physical and psychological elements cannot easily be dismissed or disregarded. Using this framework, we can see that nearly every diagnosis is “psychosomatic” in the true sense of the term. Every condition has an effect on both the mind and body.

Different Types of Pain and the Psychosomatic Stigma

In everyday usage, the term psychosomatic has grown to erroneously mean, “a health condition that is experienced in the body but only exists in the mind.” According to the Cleveland Clinic, “A psychosomatic disorder is a psychological condition involving the occurrence of physical symptoms, usually lacking a medical explanation.” While this definition acknowledges that mental conditions can produce real physical symptoms, it falls short of recognizing the inseparable relationship between the mind and body.

Everyone knows that physical pain or discomfort has a profound impact on one’s state of mind. While most tissues in the body have pain receptors, the experience of pain only happens in the mind. Despite this, pain after an injury or acute illness is taken seriously and rarely dismissed as psychosomatic. As a result, painkillers, opioids, and analgesics are some of the most prescribed medications and most purchased over the counter substances.

Chronic pain, idiopathic pain (pain without a known cause), and even pain experienced by minority groups and especially women, are likely not to be taken seriously. Pain and other mental processes have profound impacts on the body. Most people have experienced an anxious episode that causes the heart to pound, skin to sweat, body temperature change, and can increase muscle tension and pain.

Such definitions also lead to a false assumption that any condition “lacking a medical explanation” must be psychosomatic or “imagined”. The mind and body are a two-way street which influence each other at every level at all times. Misuse of the term ‘psychosomatic’ has served to undermine approaches which address this essential integrated relationship.

There is even a field of medicine called Psychosomatic Medicine which addresses the dynamic relationship between the mind and the body. Given the misunderstanding of this name, some now refer to this field as biobehavioral, biopsychosocial, or mind-body medicine. According to the journal of Psychotherapy and Psychosomatics, this field entails:

“(1) assessment of psychosocial factors affecting individual vulnerability, course and outcome of any type of disease; (2) holistic consideration of patient care in clinical practice; (3) integration of psychological therapies in the prevention, treatment and rehabilitation of medical disease.”

 

Behavioral Medicine: A Naturopathic Approach to Mental Health

Naturopathic Doctors are trained in primary care comparably to Medical Doctors and Doctors of Osteopathic Medicine. Additionally, Naturopathic Doctors receive extensive training in behavioral medicine which is aligned with a Naturopath’s “holistic approach” to health care. Naturopathic Doctor’s are one of many medical and mental health professions which utilize the behavioral medicine framework and its tools. Doctors, counselors, nutritionists, public health professionals and many others can use behavioral medicine to improve treatment, prevention, and development of health programs. Even the Cleveland Clinic is using this method to address some of the conditions listed at the beginning of this article such as IBS and IBD.

Naturopathic Doctors stand in a unique position between conventional and alternative, between mind and body, between natural and pharmaceutical approaches to human health and well-being. If you feel that you have been dismissed, stigmatized, underdiagnosed, or undertreated consider booking an appointment with a Naturopathic Doctor who will use the framework of behavioral medicine to provide you with the best possible care.

 

Call our office to make your appointment: 303-884-7557.

 

Dekker J, Stauder A, Penedo FJ. Defining the Field of Behavioral Medicine: A Collaborative Endeavor. Int J Behav Med. 2017 Feb;24(1):21-24. doi: 10.1007/s12529-016-9616-1. PMID: 27882490; PMCID: PMC5288415.

Digestive. “New Behavioral Medicine Program Helps Digestive Disease Patients Cope.” Consult QD, Consult QD, 23 Jan. 2017, https://consultqd.clevelandclinic.org/new-behavioral-medicine-program-helps-digestive-disease-patients-cope/#:~:text=Behavioral%20medicine%20addresses%20a%20range,ability%20to%20cope%20with%20it.

Fava, Giovanni A., and Nicoletta Sonino. “Psychosomatic medicine: a name to keep.” Psychotherapy and psychosomatics 79.1 (2009): 1.

Morris, Theresa, and Mia Schulman. “Race inequality in epidural use and regional anesthesia failure in labor and birth: an examination of women’s experience.” Sexual & Reproductive Healthcare 5.4 (2014): 188-194.

https://consultqd.clevelandclinic.org/new-behavioral-medicine-program-helps-digestive-disease-patients-cope/

Schäfer, Gráinne, et al. “Health care providers’ judgments in chronic pain: the influence of gender and trustworthiness.” Pain 157.8 (2016): 1618-1625.