Psychosomatic Approach to Fibromyalgia Syndrome: Medical, Psychological, and Social Aspects

Management of patients who describe chronic pain all over the body, associated with a range of symptoms as sleep disturbance, overwhelming fatigue, alteration in mood, or psychological distress that worsens the quality of life, is often complex and challenging. This syndrome has been named by terms such as “neurasthenia,” “fibrositis,” and “fibromyalgia”. At the present time, fibromyalgia is considered the most common central sensitivity syndrome, affecting over 5% of the population, being often observed in people with rheumatic conditions. While typically presenting in middle-aged women, fibromyalgia can affect both sexes at any age. The causes of fibromyalgia remain unknown. Significant research findings have focused on dysfunction of central pain processing, with defects in the ascending and descending pain pathways leading to increased pain perception. There are two methods used in the diagnosis of fibromyalgia: criteria-based diagnosis and clinical diagnosis. Although fibromyalgia defies definitively efficacious management, much evidence underlies the importance of treating the psychological factors that affect pain management process. The primary purpose of this paper is to provide a psychosomatic approach to fibromyalgia from three points of view of processing: the viewpoint of the medical profession, the position of the psychologist, and finally the way of thinking of people.

Psychosomatic Inpatient Rehabilitation for People with Depression in Germany

In Germany, inpatient therapy for depression mainly takes place in either health insurance-financed psychiatric hospitals, or in pension insurance-financed, psychotherapy-focused, psychosomatic rehabilitation hospitals. In psychiatric hospitals, the diagnosis is made according to the International Classification of Diseases (ICD), and therapeutic attempts are made to achieve remission, whereas in rehabilitation hospitals, the International Classification of Functioning, Disability and Health (ICF) plays an essential diagnostic role. Accordingly, the main German pension insurance, Deutsche Rentenversicherung, has developed a rehabilitation therapy standard for depressive disorders. In this chapter, we focus on the psychotherapeutic inpatient rehabilitation for patients with depression based on an example of a specialized psychotherapeutic hospital. This example illustrates how psychotherapeutic inpatient rehabilitation can be tailored to the individual’s needs and may include any of the following therapeutic modalities: Cognitive Behavior Therapy (CBT), Schema Therapy, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), pharmacotherapy, group therapy for comorbid conditions, skills training, psychoeducation, occupational therapy (OT), movement therapy, physiotherapy, music therapy, social work, family work, and self-help groups. People with depression may benefit from this service model of psychosomatic inpatient rehabilitation beyond symptom remission, as it focuses on increasing people’s functional level as well as their quality of life.

Psychological and Societal Implications of Projecting the Shadow on the Feminine in Tibetan Buddhist Contexts

Idealizing and medicalizing of methods ascribed to Buddhism has led to individualizing their structural and societal challenges. Although the long-undervalued need for introspection may get addressed, people are now caught under the cloak of spirituality hoping for quick enlightenment or a panacea solving mental diseases. Thus, at this point, the impact of decontextualizing concepts, unreflectively copying feudal structures into Tibetan Buddhist seminar- and meditation-centers, as well as of lacking knowledge required for the gradual application-oriented learning processes taught in traditional Buddhist philosophy have become clear. This shows in recent testimony of economical, psychological, and physical abuse in international Tibetan Buddhist organizations. The violence against individuals and man-made trauma in such contexts need to get analyzed before the background of neologisms, that is concepts allowing for arbitrariness and violence in the name of spirituality, as well as of the sophisticated systems of rationalizing damage and silencing trauma and victims. Furthermore, though those in the ‘inner circles’ run the risk of traumatization and of being held accountable, it is women who are at higher risk, particularly those who engage in secret relationships. Thus, in terms of treatment, the collectively projecting the shadow on the feminine, leading to an attitude of exploitation and control against women, requires consideration.

Assessing the Effectiveness of Brief and Low Intensity Psychological Interventions for Medically Unexplained Symptoms and Health Anxiety: A Systematic Review of the Literature

This chapter presents a systematic review of the literature to assess the effectiveness of brief psychological interventions for medically unexplained symptoms (MUS)/somatic symptom disorder, non-cardiac chest pain, and illness anxiety disorder or health anxiety (HA). Google Scholar, PubMed, and Web of Science were searched as data sources. Reference lists were subsequently examined for other relevant articles. Studies were assessed according to specified inclusion criteria and extracted according to PRISMA guidelines. A total of 23 studies were included in the final synthesis. Significant effects for intervention groups relative to control groups were reported in 19 studies, whilst 4 studies did not determine any significant benefits of interventions compared with controls. All of the brief interventions (CBT, psychosocial, psychophysiological, psychosomatic, relaxation and group therapy), with the exception of metaphor therapy, showed significant effects relative to controls in at least one study. The evidence suggests that brief psychological interventions, more specifically time limited CBT based interventions may be effective in treating HA and MUS with psychological distress. Findings are comparable with other reviews. Future research may facilitate the piloting of an intervention, and there remains a need to provide more robust evidence of cost effectiveness.

The Network Paradigm: New Niches for Psychosomatic Medicine

Psychosomatic medicine, as a philosophical frame and practical approach of the diagnostic and therapeutical agency, had been undergone several renewals and reframing in the past. We overview the history of psychosomatics and map its branches. Psychoanalytic and psychodynamic frameworks, the Engelian biopsychosocial concept, the paradigm of behavioral medicine, the clinical psychophysiological research background, the clinical fields of PNI, psychocardiology, biobehavioral oncology, the so-called mind-body medicine, and stress medicine frameworks reflect a converging pluralism. Psychoneuroimmunology offers a comprehensive framework to analyze key issues of psychosomatics in a social neuroscience framework and to demonstrate the significance of the network approach in bridging the gap between psychosomatics and biomedicine. Network medicine creates a shared denominator for analyzing socioeconomic, interpersonal, life event-based narrative factors together with psychophysiological features of the clinical and health psychological problems and promotes convergence of psychosomatics, biomedicine, and lifestyle medicine, too. On the other side, psychosomatic medicine as a particular professional medical specialization is not universal at all. In Europe, one can find such specialization only in Germany, while psychotherapy applied by somatic experts is practiced in wider circles. Finally, we explore the new niches for psychosomatic orientation offered by integrative frameworks like lifestyle medicine and network medicine.

Emotional Eating and Obesity

The first time that terms such as food addiction and addictive eating were mentioned was in 1956, in an article by T.G. Randolph. Recently, from a psychosomatic point of view, some authors have linked obesity and food addiction. Along with the concept of food addiction (derived from the similarities between the consumption of certain foods and “substance addictions”), a couple of questions seem to arise: What if it’s not just the particular food (the substance) that we are addicted to? Could it be that we are addicted to something else that makes us eat it? Thus, the concept of eating addiction has its own set of particulars. It brings the attention back to the individual and not the external substance (the food or ingredient). The focus on confronting the obesity problem should be moved away from the food itself (the addictive substance) to the person’s act of eating (the addictive behavior). Undoubtedly, there are many links between emotions and overweight/obesity. This chapter aims to review the current state of this field of study which is the emotional basis of obesity (at least a particular case of obesity and weight-related disorders).

Post-Traumatic Stress Disorder in Children and Adolescents: Some Recent Research Findings

Childhood trauma can have a profound effect on development, with a lifelong impact on physical growth, psychological development, and mental health. This chapter provides a framework for adolescent health professionals to understand the impacts of traumatic stress on children and adolescents. This chapter mainly takes the Wenchuan Earthquake studies in China as an example, and reviews recent research findings on epidemiological characteristics of PTSD and related mental disorders, as well as on possible influencing factors and mechanisms for post-traumatic adaptation in children and adolescents. Important intervention strategies for PTSD in children and adolescents are introduced. Prospects for future research are also discussed.

Use of Falun Gong to Address Traumatic Stress among Marginalized Clients

Although mental health service providers have focused on the effects of trauma and related interventions for decades, little is known about pervasive and historic trauma, particularly for socially marginalized individuals. Thus, clinical issues associated with sociopolitical oppression have been under-investigated. Coupled with the lack of sufficient cultural competence when working with diverse clients, mainstream clinicians frequently lack adequate case conceptualization skills and culturally sensitive interventions to assist clients from diverse backgrounds. Using traumatic stress as a framework for exploring evidence-based interventions to address long-term, pervasive marginalization and its psychological effects, the authors propose that mindfulness techniques are particularly beneficial to this client population. The authors reviewed culture-centered interventions to address traumatic stress for marginalized client populations, focusing on the mindfulness practice of Falun Gong. Recommendations for practice include the inclusion of traumatic stress theory and techniques in pre-service training, professional development training for practitioners focusing on mindfulness techniques with clients assessed with historical trauma, and Web-based training for clinical faculty to enhance their knowledge about traumatic stress, historical trauma, and associated interventions for clients from marginalized communities. The authors offer recommendations for future research that focuses on studies exploring the usefulness of Falun Gong in working with clients with traumatic stress.

Psychosomatic Medicine and Palliative Care

Psychosomatic medicine (MP) and palliative care are disciplines with history and both are based in the scientific world. Although the psychosomatic diagnosis is exclusionary, it can help palliative care to be more effective. The influence of the psychosomatic in the palliative exists. According to all the bibliography available in the electronic databases, psychosomatic medicine is a biopsychosocial model related to both physical and psychosocial factors, which helps improve the care of patients with advanced cancer in palliative care (improved survival, quality of life, reduces the burden on caregivers). It helps analyze and address psychiatric disorders, as well as in the control of complex symptoms such as life-threatening anxiety, depression or delirium. Therefore, both medical disciplines are related from the beginning and help to the quality of life of terminally ill patients.