Health ministry of republic of moldova the university of medicine and pharmacy nicolae testemiţanu

 
2. Psychosomatic (somatoform) disorders 
Some physical diseases are believed to have a mental component 
derived from the stresses and strains of everyday living. This is the case, 
for example, of lower back pain and high blood pressure, which appear 
to be partly related to stresses in everyday life. Psychosomatic disorders 
are disorders in which mental factors play a significant role in the deve-
lopment, expression, or resolution of a physical illness. 
Unfortunately, when an illness is labeled psychosomatic there is 
often an immediate stigma or negative perception associated with it.
Very often, when an individual suffering from neck pain, back pain 
and hears the term psychosomatic, they immediately respond defensively. 
When a condition is labeled as psychosomatic the connotation attached is 
that the condition is "all in the mind" or somehow "imaginary." There is 
even a mental illness stigma attached, with the patient protesting, "I am 
not crazy, this pain is real!" Even people close, at times members of the 
individual's own family, will say unkind things like, "I knew he was 
faking it" or "I knew she was just trying to get attention, I felt sorry for 
her!" For these reasons and others, the resistance to a psychosomatic 
diagnosis is considerable, often socially and culturally based. 
It is difficult to classify some disorders as purely physical, or purely 
somatoform. However, while it is necessary to identify if an illness has a 

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physical basis, it is recognized more and more that the effort to identify 
disorders as purely physical or mixed psychosomatic is increasingly 
obsolete as almost all physical illness have mental factors that determine 
their onset, presentation, maintenance, susceptibility to treatment, and 
resolution. Addressing such factors is the remit of the applied field of 
behavioral medicine. In modern society, psychosomatic aspects of 
illness are often attributed to stress, making the remediation of stress one 
important factor in the development, treatment, and prevention of psy-
chosomatic illness. 
In
 
psychodynamic theory,
somatization is conceptualized as an 
ego 
defense 
- the unconscious rechanneling of repressed emotions into so-
matic symptoms. Sigmund Freud's famous case study of Anna O. featu-
red a woman who suffered from numerous physical symptoms, which 
Freud believed were the result of repressed grief over her father's illness.