Lesson 6: Somatic Symptoms and Related Disorders and Dissociative Disorders


Attention

Somatoform, Dissociative, and Mood Disorders


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Create a case study that exemplifies the state of a Somatic Disorder.

Teaching

Chapter 6: Somatic Symptoms and Related Disorders and Dissociative Disorders

Somatic Disorders

Chapter 6 begins with a compelling question...have you every known somone who you would consider a "hypochondriac?" We usually associate this with individuals who claim to be sick often but really are not.

We have to understand that there is a difference between individuals who fabricate illness for gain and those who truly believe and/or experience that they are having physical symptoms where the evidence of the symptoms are not present.

  • Somatic Symptom Disorder
  • Illness Anxiety Disorder
  • Psychological Factors Affecting Medical Conditions
  • Conversion Disorder
  • Factitious Disorders

As you can see from these names, the first three are related to anxiety disorders and can be understood in this fashion.

Figure 6.1 in your text describes the process by which someone becomes anxious about their body symptoms.

These disorders have been very resistent to treatement because once doctors have determined there is "nothing wrong with you" they rarely have time to spend reassuring you that you are doing OK (despite the feelings that you have.) Research has supported (p. 188 in your text) that entering into "explanatory therapy" was associated with a significant reduction in symptoms.

Conversion Disorder

This is certainly one of the most fascinating of the disorders. Usually associated with the onset of blindness or paralysis, the individual enteres into the state and truly experiences the symptoms. Some might even experience seizures.

I have personally experienced this disorder in a very close friend of mine. At first this person seemed to experience the symptoms of a stroke but over the weeks and months to follow she experienced blindness, numbness, paralysis, and full-grand mal seizures (without one stitch of objective evidence of what was happening.

Once when she had a seizure she was also hooked up to an EEG that was measuring brain waves. While she had a lot of activity in her brain, and her physical body was convusling and she was unconscious, the EEG did not measure any of the brain waves associated with a seizure. As far as the picture of the electrical activity in her brain was concerned, she did not have a seizure.

Faking It

The term used to describe those who might be "faking" their symptoms is "malingering". "Factitious Disorders" also in our list, lays somewhere bewteen malingering and conversion disorders.

Dissociative Disorders

Have you every had a day dream and then suddenly you find yourself flung back into reality? Have you every been hypnotized?

Day dreaming and the state of hyponosis are two points along a continuum of dissociation, or a cognitive separation between your thoughts and your physical body. Nearly everyone has the capacity to day dream, relatively few people have the capacity to be hypnotized.

Other dissociative disorders include:

  • Depersonalization Disorder
  • Dissociative Amnesia
  • Borderline Personality Disorder or Complex Post-traumatic Stess Disorder (not included in your book's list of related disorders, but thought by many to have dissociative features.)
  • Dissociative Identity Disorder (used to be Multiple Personality Disorder)


Assessment

Lesson 6 Assignment

Please complete the following task in a document:

  1. Cover page
  2. Create a story of a fictitious person with a Somatic disorder.
  3. Tell the story in narrative format for 1-3 paragraphs.
  4. In the story, highlight the specific instances of symptoms that you would identify in diagnosing the person with the somatic disorder you chose and number each one.
  5. At the end of paper list the numbers that correspond with each instance of a symptom and write next to that number the specific diagnostic criteria that the symptom is associated with.

Lesson 6 Discussion

Review the video in the lesson plan of the woman with six personalities. What is your first impression of this person? Review the section in the book titled "Can DID be Faked" (p. 201) and comment on this video.