Coping with somatic symptom disorder

coping with Somatic symptom disorder

Somatic symptom disorder facts


People with somatic symptom disorder (SSD) can suffer a lot from their symptoms and may devote a lot of time and energy on their symptoms and health on a daily basis. Furthermore, a lot of people with SSD feel a lack of support and understanding for their physical symptoms, especially when general practitioners can’t find anything that fully explains their pain. Feelings of helplessness, fear and anxiety, irritation, frustration, and even anger are common for people with SSD. Coping with somatic symptom disorder, therefore, focuses on a reduction of the severity of the SSD symptoms and those feelings of helplessness, fear and anxiety, irritation, frustration, and anger.
NOTE: Coping with somatic symptom disorder can be difficult, especially for those with severe SSD, because of the uncertainty they experience: ‘what if there is something really wrong with me?’, ‘what if the doctor missed something?’. Please, be sure to visit your general practitioner to make sure there is nothing wrong with you if you suffer from certain physical symptoms. Only use the tips on this page if you are diagnosed with SSD by a professional.
 

 
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  • What is Somatic Symptom Disorder (SSD)?
  • What causes SSD?
  • Diagnosing SSD.
  • How can SSD be treated?
  • Take the SSD test.
  • Living with someone who has SSD.
  • Interesting SSD facts.
  • Online counseling for SSD
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    At Barends Psychology Practice, we offer (online) therapy for somatic symptom disorder. Contact us to schedule a first, free of charge, online session. (Depending on your health insurance, treatment may be reimbursed).

     
     

    Visit your general practitioner

    If you are suffering from somatic symptom disorder (SSD) symptoms and you haven’t visited a general practitioner first, we strongly recommend you to schedule an appointment to determine its cause. It may be that you are suffering from a medical condition that can fully explain why you are suffering from certain physical symptoms.
    This coping with somatic symptom disorder page is only for those who’s physical symptoms cannot be fully explained by a medical condition, or for those who’s general practitioner thinks it may be SSD.
     
     

    Coping with somatic symptom disorder – traumatic experiences

    One of the most important things to do is to determine when the somatic symptoms started to bother you. Somatic symptoms can develop after experiencing something traumatic. Almost 50% of the people with SSD have been traumatized by their primary caretaker(s) [1], and applying Eye Movement Desensitization and Reprocessing (EMDR) on these experiences can reduce the impact of these somatic symptoms significantly [2],[3],[4]. If you want to know whether or not you experienced something traumatic, please take the free online PTSD questionnaire.
    Coping with somatic symptom disorder on your own is a lot easier, and most likely more effective, if the cause is not trauma related. If it is trauma related, please consider visiting a therapist specialized in EMDR. At Barends Psychology Practice, we offer EMDR therapy for somatic symptoms.
     
     

    Coping with somatic symptom disorder – disproportionate and persistent thoughts

    Having disproportionate and persistent thoughts about the seriousness of one’s symptoms is one of the characteristics of SSD, and is something people can reduce on their own. These thoughts are accompanied by uncertainty: ‘what if I have a rare medical condition?’ and usually cause people to worry and feel distressed. This uncertainty can create an attention bias (being affected by recurring thoughts) and memory bias (enhanced memory for disorder congruent information) [5] for physical sensations in someone’s body and can make people mistake normal physical sensations for SSD symptoms. Coping with somatic symptom disorder means learning how to reduce these distressing thoughts and the uncertainty accompanying it.
     
    How can you do that?

    • Practice meditation/mindfulness: Meditation and mindfulness are effective in the reduction of persistent and worry-related thoughts [6] and pain symptoms [7],[8] and chronic pain [9] also when someone practices mindfulness a home [8]. With mindfulness and meditation someone focuses on accepting the pain-related thoughts as something that does not need to affect your life. As a result, people focus less and less on these pain related thoughts.
    • Balance negative thoughts: the aforementioned attention bias and memory bias cause people to have more negative, disproportionate, and persistent SSD related thoughts. These thoughts negatively affect your feelings and judgment. It is, therefore, important to balance these negative thoughts by countering them with positive, rational thoughts. Try to come up wih 2 positive thoughts for each negative SSD related thought that pops up. For instance, if you feel pain in your joints and you are afraid that something may be wrong, focus on the fact that you can still do something despite the joint pain and that you are tougher/stronger than the pain.
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    • Neutralize worst fear: some people fear having a rare/incurable medical condition. Thinking about having this particular medical condition can be very upsetting and distressing, and can negatively affect someone’s daily life. If the fear of having a rare/incurable medical condition on a 10 point scale reaches a 6 or higher, it is worth considering EMDR to neutralize this worst fear [10]. It usually takes 1 to 2 sessions to neutralize such a fear. For more information on EMDR, please read: therapy types.
    • Distract yourself: An easy technique to focus less on these persistent and disproportionate thoughts is to keep yourself busy. Make sure you have something challenging to do. Watching television may not be distracting enough. Instead, read an interesting book or try a puzzle/sudoku.
    • Test the right hypothesis: Most people who are concerned about certain physical sensations are afraid of having an unnoticed life threatening medical condition. Every physical sensation is a confirmation of their concerns. The problem with looking at physical sensations like this is that even normal sensations will be misinterpreted on the long run. For instance, neck pain after a bad night’s sleep. These people are testing the wrong hypothesis. Ideally they would test the following hypothesis: each physical sensation is feedback from my body to movement or stress. Shortness of breath after walking the stairs is more likely caused by walking the stairs, even if it takes a while to recover. If, at the same time, that person has a stressful day, it is likely that this person will experience more physical sensations. In a way your body is telling you to take it easy.
    • Use self-talk: Whenever a SSD thought pops up, tell yourself that you don’t need to think about it right now, because you have more important things to do at the moment. Instead, schedule 10 minutes at the end of the day when you allow yourself to think about your SSD symptoms. If an SSD related thought pops up, tell yourself that you will think about this later on the day.

     
     

    Literature

    • [1] Annemiek van, D., Julian D, F., Onno van der, H., Maarten JM, V. S., Peter GM, V. D. H., & Martina, B. (2011). Childhood traumatization by primary caretaker and affect dysregulation in patients with borderline personality disorder and somatoform disorder. European Journal of Psychotraumatology, 2, 5628.
    • [2] van Rood, Y. R., & de Roos, C. (2009). EMDR in the treatment of medically unexplained symptoms: A systematic review. Journal of EMDR Practice and Research, 3, 248-263.
    • [3] Schneider, J., Hofmann, A., Rost, C., & Shapiro, F. (2007). EMDR in the treatment of chronic phantom limb pain. Pain Medicine, 9, 76-82.
    • [4] Demirci, O. O., Sağaltıcı, E., Yıldırım, A., & Boysan, M. (2017). Comparison of Eye Movement Desensitization and Reprocessing (EMDR) and Duloxetine Treatment Outcomes in Women Patients with Somatic Symptom Disorder. Sleep and Hypnosis, 19, 70-77.
    • [5] Pauli, P., & Alpers, G. W. (2002). Memory bias in patients with hypochondriasis and somatoform pain disorder. Journal of Psychosomatic Research, 52, 45-53.
    • [6] Lenze, E. J., Hickman, S., Hershey, T., Wendleton, L., Ly, K., Dixon, D., … & Wetherell, J. L. (2014). Mindfulness‐based stress reduction for older adults with worry symptoms and co‐occurring cognitive dysfunction. International journal of geriatric psychiatry, 29, 991-1000.
    • [7] Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of personality and social psychology, 84, 822.
    • [8] Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of behavioral medicine, 31, 23-33.
    • [9] Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010). Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. Journal of psychosomatic research, 68, 29-36.
    • [10] Marr, J. (2012). EMDR treatment of obsessive-compulsive disorder: Preliminary research. Journal of EMDR Practice and Research, 6, 2-15.