Cognitive Behaviour Therapy appears to be the most effective form of treatment for Somatoform Disorders.
Psychotherapy is aimed at helping the person to express their feelings more appropriately by exploring the links between the symptoms and emotional factors.
While it hasn't been shown to decrease pain levels, for example, it has been shown to reduce health care costs during the first year after treatment.Psychophysiologists have described several mechanisms that produce somatic symptoms where there is no organic pathology or real cause. These mechanisms include overactivity or dysregulation of the autonomic nervous system, smooth muscles contractions, endocrine overactivity and hyperventilation.
There are various techniques for reducing the physiological arousal and discomfit associated with Somatoform symptoms and some have been shown to have some positive effects, eg biofeedback, guided imagery, progressive muscle relaxation exercises and hypnotherapy.This has been found to be very effective in reducing the patient's levels of stress in relation to their symptoms. Visits should be scheduled every 4 to 6 weeks, instead of 'as needed'
Something as simple as regular, scheduled physiotherapy may reduce the severity and frequency of symptoms, and reduce the overall cost of management for the patient.
There doesn't appear to be any readily available information on self help options that have been successfully used to treat Somatoform symptoms, although I personally have been able to interrupt or reduce the severity of my pseudo-seizures using a combination of EFT (Emotional Freedom Technique) and Reiki. Each technique on its own is not sufficiently strong enough to achieve the same results, however the combination appears to work well with a significant number of episodes of severe symptoms.
I have experienced variable levels of success and failure with other self help techniques.Behaviour modification can be used, especially to help the person overcome learned helplessness. Frequent rewards for small goals can help, along with family not rewarding any maladaptive behaviours.
The patient may need to learn that their spouse or parent is not their nurse!It appears from the literature that there is only limited benefit from drug therapies, with the following exceptions:
St John's wort for somatization, amitriptyline and duloxetine for fibromyalgia, and teaserod and alosetron for IBS.Other options include MultiDisciplinary Pain Centres and Family Therapy.
If you become aware of any other successful treatment options and would like to see them included here, please send an email to vivienne@somatoformaustralia.org