The Mind-Body Interface in Somatization: When Symptom Becomes Disease represents a unique contribution to the clinician's tool chest for diagnosing and treating psychosomatic illness. This book breaks new ground by asking and answering many of the key questions that trouble every practicing clinician: Why do patients use somatization? Can we predict who will be a somatizer? Is there an underlying process involved? Why are these patients so difficult to treat?
Beginning with a discussion of contemporary disease classification, The Mind-Body Interface in Somatization clarifies matters greatly by talking in terms of chronic and situational somatization, showing that chronic patients use illness as a way of life, while situational patients somatically respond to existential crises, and revealing how both are rooted in the mind-body interface. Drawing on elements of personality theory, the authors discuss the core conflicts and character structure inherent in both types of somatization and suggest treatment options appropriately geared toward the needs of each. The Mind-Body Interface in Somatization describes how chronic somatization can be addressed by cognitive-behavioral therapy and Dialectical Behavioral Therapy, while situational somatization can be managed with short-term existential psychotherapy. Concluding with a discussion of medications that may be helpful to the somatizing patient, this volume represents an original approach to explaining what goes on in the mind of the somatizer.
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"This is a much needed book on a long neglected topic. Somatization is a problem that has been well-described but poorly understood for many years. The book is illuminating. Jonathan Cole's contribution, probably the last words he wrote for publication in his long life, is classic Cole: wise yet playful, cautious yet ready to take action, acknowledging uncertainty yet offering hope. It is so typical of him that his last statement in clinical psychopharmacology, a field he had founded 50 years before with a handful of others, was a thoughtful, provocative, nicely researched little essay concerning an area that few had thought about and about which only a little was known."—J. Alexander Bodkin, MD, chief of the Clinical Psychopharmacology Research Program, McLean Hospital
"The authors tackle the complexity of somatization head on. Neuroplasticity, ego psychology, existential psychotherapy, and psychopharmacology are all given their due. Treatment recommendations are useful and solid."—Walter A Brown, MD, clinical professor of psychiatry, Brown University and Tufts University School of Medicine
"Somatization is an underappreciated aspect of medical care. This book addresses the need to weave the science and the art of medicine into a whole. Individuals are a complexity of physiologic and emotional interactions influenced by cultural expectations, societal norms, personal experiences, and spiritual orientation. The authors recognize this truth. This book challenges us to examine professional objectiveness and scientific certainty while remembering that there is a person within the patient that presents to the clinician."—Bruce P. Bates, DO, chair, Departments of Geriatric Medicine and Family Medicine, University of New England College of Osteopathic Medicine
* 1: Somatization and the Power of Conventional Wisdom
* 2: Somatization and Its Discontents
* 3: A View from outside the Box
* 4: Ambivalence and Progressive Regression in Somatization
* 5: Perception and Multi-Level Perceptual Diagnosis
* 6: Dealing with Impasse Resistance
* 7: Cognitive Behavioral Treatments of Chronic Somatization
* 8: Dialectical Behavior Therapy and Chronic Somatization
* 9: The Situational Somatizing Patient in Treatment
* 10: Psychopharmacology and Somatization
* 11: Death or Transformation
About the Authors:
W. Lynn Smith, PhD, ABPN, was an associate clinical professor of anesthesiology at the University of Colorado Health Sciences Center and for more than forty years specialized in the diagnosis and treatment of somatizing syndromes. He founded and operated the first hospital-based neuropsychological laboratories in the United States, where he did considerable research in personality, chronic pain, and psychosomatics.
Patrick W. Conway, MDiv, has more than thirty years of experience in the fields of pastoral ministry and counseling. He has practiced as a psychotherapist in hospital-based psychiatric settings and is certified in the delivery of Dialectical Behavior Therapy.
Jonathan O. Cole, MD, ABPN, was professor of psychiatry at Harvard Medical School and a Senior Consultant at McLean Psychiatric Hospital (Belmont, Massachusetts).