| T O P I C R E V I E W |
| robin |
Posted - 06/13/2004 : 13:23:03
Is anyone familiar with the DSM IV diagnosis of Somatization Disorder? If so, how is that any different from TMS? It is amazing during some of my research on somatization that the prognosis is so poor. I think that the two are one in the same, therefore the same techniques that you deal with tms would work for somatization disorder. Any thoughts? |
| 9 L A T E S T R E P L I E S (Newest First) |
| Indy |
Posted - 03/23/2006 : 08:45:16
I see TMS and Somatization Disorder as a matter of semantics. Everyone working with clients/patients who have manifested physical symptoms as a result of earlier childhood traumas, whether they are conscious or unconscious memories, would agree that it's how the mind/brain inteprets experience which leads to painful emotions and then repressed, then disease, etc. My take on the so-called "difference" is how the clinical practitioner "treats" the condition. If you "treat" the mind (brain), then your focus is not necessarily on the body (physical)as in psychiatry. If you "treat" the body (as in physiotherapy for example), then your focus is not necessarily on the mental aspects of what created the problem in the first place. A person can't have a painful emotion unless they first had a painful thought. From what I've read about Somatization, most of the practictioners seem to be clinical psychologists and work only work with the mind (is that being fair of me to say?). Clinical application for TMS, on the other hand, focuses on the mind but understands the connection to the body, whereas Somatization techniques do not necessarily agree that the physical symptoms are real. In other words, what is going on in the body is the same no matter what you call it; how you intepret what is going on in the mind and body is up for intepretation and clinical "disease labelling". "Holistic therapies", on the other hand, are all about working with mental, emotional, physical, and spiritual aspects of disease (or should be) in a very real and practical way.
PS I'm new to this forum, but have been working as a holistic practioner with clients for a long time to help them see the connection between their disorders and their earlier childhood experiences. I just didn't know what to call the techniques that I use with them. TMS is the closest "label" I can find. I would like to hear from other people who are practicing holistic techniques both for pain and other disorders. I want to know more about what I can do for the "wounded" people who reach me. |
| Suzanne |
Posted - 06/23/2004 : 13:30:15
Hi Robin,
Sorry this took so long, but I missed my last weeks session.
Dr. Sherman, My TMS Psychologist in NYC, referred by Sarno, said that Somatization and TMS are basically interchangeable, but that the prognosis for somatization patients is poor because of a few things. First off, they go through the healthcare system and can get a diagnosis recognized by their insurance and reimbursed. Then, they can go apply for medical leaves of absence and workman's comp, social security, (all those benefits when you're dx'ed and "unable" to hold a job) because they have a "legitimate" diagnosis recognized by the healthcare system. This in turn leads them to get worse and live off any other means aside from keeping a job and being productive. He also said that if you were to compare the TMS people to the Somatization people, you'd notice a different class of people. People who go to Dr. Sarno or TMS doctors are not looking for help and real answers, a "cure" to their pain. People who go through the healthcare or state aid system are looking for help initially, but seem to them turn to looking for excuses to avoid working, and getting well, to keep feeling bad and keep checks coming in or other means of staying "ill."
I'm not remembering this all exactly as he told me, but the gist. He said both are indeed treated the same, at least by him. He also said that some or most patients have a poor prognosis because they don't really accept the diagnosis at all. (not speaking his in general, but the population) He said TMS patients are far more accepting of the TMS diagnosis than a somatization disorder patient. He said that's why dealing with them was a whole different ballgame - their lack of acceptace of the pain coming their unconcious mind, or any psychological reason at all.
OK, almost caught by the boss, had to hide the forum FAST. I'll try to remember more later tonight. If I do, I'll post again. |
| Suzanne |
Posted - 06/14/2004 : 17:39:44
Robin,
I'll let you know what I find out. He doesn't BS me around. He's very honest and straight forward. He said "If you had something worse, I'd be up front. I've had worse patients, and people with TMS AND other problems/disorders...". Since I'd researched so much before finding Sarno and TMS info, I was quite paranoid by the time I got to the TMS psychologist. (Eric Sherman, the one in the MBP acknowledgments) I figured I was doomed. All that researching was more harmful than good in my case.
Anything I can find out, I'll pass along to you. |
| robin |
Posted - 06/14/2004 : 14:04:55
Suzanne,
I am glad that you are on the same page as I am in terms of the definition. Your quotes are straight from the DSM-IV. The diagnosis of Somatization Disorder requires quite a few maladies, for ex: four pain symptoms, two g.i. symptoms, one sexual symptom, and one pseudoneurological symptom. If you don't meet all of those, then you can be diagnosed with Undifferentiated Somatoform Disorder. I obviously know that not all tms'ers have 4,2,1,and 1 symptom in those categories,but the general idea is very similar.
I am very curious if your psych just doesn't want you to think that you are THAT bad, so steers you away from the terminology. Also, why would people with MORE symptoms not be able to treat their issues the same way as someone who might not have ALL in order to make the specific diagnosis? Let me know what your psych says, I am curious as to what the professional opinion is on this from someone who is familiar with both. THANKS
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| Suzanne |
Posted - 06/14/2004 : 10:27:05
Dave,
According to my TMS psych., and from a quick search now, Somatization is not described as "all in the head." I'll have to ask him on Wed. if he did say it was "all in the head" or similar to TMS. I thought he said somatization was physical symptoms caused by psychological problems.
It does seem similar, to me, but as my psych said to me, "ignore the Somatization diag. on your bills, you do NOT have Somatization Disorder"
"A person with somatization disorder has numerous physical symptoms over many years that suggest the person has a medical illness, but the symptoms cannot be explained fully by a medical diagnosis. The symptoms, called somatic complaints, cause significant distress or impair the person's ability to function. The symptoms are real: The patient is not "faking," and the symptoms are not under the person's conscious control."
and
"The disorder is marked by multiple physical complaints that persist for years involving any body system. Most frequently, the complaints involve chronic pain and problems with the digestive system, the nervous system, and the reproductive system. The disorder usually begins before the age of 30 and occurs more often in females.
Somatization disorder is highly stigmatizated and patients are often dismissed by their physicians as having problems that are "all in your head." However, as researchers study the connections between the brain, the digestive system, and the immune system, these disorders are becoming better understood and should not be seen as "faked" conditions which the patient could end if he or she chose to do so.
The symptoms are severe enough to lead the person to visit the doctor or take medication, and the symptoms interfere with work and relationships. A lifelong history of sickliness is often present, though no specific disease is ever identified to account for the symptoms. A greater intensity of symptoms often occurs with stress."
For curiosity, I'm going to ask what the difference is. |
| robin |
Posted - 06/14/2004 : 10:21:44
I still don't quite understand if there is any difference at all between somatization disorder and tms. The DSM IV defines pain disorder (a subset of Somatization disorder) as "characterized by pain as the predominant focus of clinical attention. In addition, psychological factors are judged to have an important role in its onset, severity, exacerbation, and maintenance." Is that not the same as tms?
I am only perpetuating this discussion because I have to present this diagnosis to a psychopathology class of mine and I want to offer treatment options... of course if I can educate my colleagues on dr. sarno I would like to.
Again, from the DSM-IV..."Symptoms that are intentionally produced should not count toward a diagnosis of Somatization Disorder."
Nowhere does it say that the symptoms are not real, only that the source is psychological.
So, I wonder how that somatization disorder is a "whole different ballgame"?? |
| Dave |
Posted - 06/14/2004 : 07:46:40
"Somatization" implies the symptoms are all in the head, they are psychologically based, they are not real.
TMS is not a somatization disorder. The symptoms are real, physical symptoms. |
| Suzanne |
Posted - 06/13/2004 : 18:38:25
Somatization Disorder is the diagnosis my TMS psychologist has to put on my invoice for billing purposes since there is no code for TMS for the healthcare system. It's the closest thing to TMS he could find. But he made sure to assure me the very first time I read my bill to NOT go look it up and read the Somatization Disorder information because of the poor prognosis. I also felt the two were very similar, because even being told not to look it up, I did. And it didn't seen very hopeful. But after the next session with my TMS psych., he assured me that TMS patients can be "cured" and to please ignore the Somatization Disorder information. He then went on to point out examples of patients he'd had over many, many years who were far worse off than me when they first came to him and are now fine, and many were seeing him for much longer than me. (I'm 2 years in, he said some took 3+ and are now pain-free and have reported back to him time to time to let him know they're OK) Telling me that some patients in the Sarno video were his patients, and are now fine, helped, too. He said they look fine in the video, but came to him in pretty bad shape. (no, he didn't tell me who they were in the video)
Another silly thing I did was do the Enneagram test at
http://www.enneagraminstitute.com/
I did the short test, twice within 6 months. I took the free, short test and the long test. Both times I came up as a #2, "The Helper" - The Caring, Interpersonal Type:
Generous, Demonstrative, People-Pleasing, and Possessive
Basic Fear: Of being unwanted, unworthy of being loved
Basic Desire: To feel loved
Empathetic, compassionate, feeling for others, caring and concerned about their needs. Thoughtful, warm-hearted, forgiving and sincere.
Unhealthy Type 2: Somatization of their aggressions result in chronic health problems.
The book actually went into detail about somatization and the peronality type.
So, in the long run, I had to put the Enneagram books away and get back on track with TMS books and IGNORE the word "somatization", since so many psychologists have negative information for improving somatization patients on their online websites. All I ever found was hopeless info and it wasn't helpful or encouraging to read.
My TMS psychologist said the dealing with Somatization Disorder patients is a whole different ballgame. |
| April |
Posted - 06/13/2004 : 17:18:52
<<...the DSM IV diagnosis of Somatization Disorder? If so, how is that any different from TMS? It is amazing during some of my research on somatization that the prognosis is so poor. I think that the two are one in the same, therefore the same techniques that you deal with tms would work for somatization disorder. >>
Hi Robin
I'm not familiar with the clinical definition of the SD diagnosis. Yet I would guess that it would include TMS. Though it wouldn't surprise me that the psychotherapy field hasn't cracked the nut on how to actually treat it from their perspective which is why the prognosis is so poor. Just a guess.
I had an experience a few years ago when I had been been in therapy and had been complaining of chronic pain which was worsening. During this time I had read Sarno's book HBP and was diagnosed with TMS by a TMS Dr. My Dr. helped me coach my therapist on how to help me with the TMS. My therapist had no trouble buying into TMS and said she had suspected that my pain may have a psychological component when I complained about all the hoops I had to jump through to learn of TMS and a Dr. that could actually help me rather than basically diagnosis me as SOL.
But I took issue with my therapist. I told her point blank her thinking to herself that my condition could be emotional did not help me. She did not know how to help me. She couldn't assure me that there was no physical reason for my pain or help me cut through my fear and know that I wasn't going to hurt myself if I started to resume activities that I had given up to pain. She didn't know on her own that it was my repressed emotions and specific personality traits that contribute to TMS and how to treat that. She did know how to work with the emotional areas that my Dr & Sarno's book recommended and that did help. This is simply my experience. I really don't know that knowledge base of therapists that work with somatization disorder. Its sad if they just don't know of Sarnos work.
April |
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