PSYCHOSOMATIC DISORDER

also called Psychophysiologic Disorder, condition in which psychological stresses adversely affect physiological (somatic) functioning to the point of distress. It is a condition of dysfunction or structural damage in bodily organs through inappropriate activation of the involuntary nervous system and the glands of internal secretion. Thus, the psychosomatic symptom emerges as a physiological concomitant of an emotional state. In a state of rage, for example, the angry person's blood pressure is likely to be elevated and his pulse and respiratory rate to be increased. When the anger passes, the heightened physiologic processes usually subside. If the person has a persistent inhibited aggression (chronic rage), however, which he is unable to express overtly, the emotional state remains unchanged, though unexpressed in the overt behaviour, and the physiological symptoms associated with the angry state persist. With time, such a person becomes aware of the physiological dysfunction. Very often he develops concern over the resulting physical signs and symptoms, but he denies or is unaware of the emotions that have evoked the symptoms. Psychosomatic disorders may affect almost any part of the body, though they are usually found in systems not under voluntary control. Research by psychiatrist Franz Alexander and his colleagues at the Chicago Institute of Psychoanalysis in the 1950s and 1960s suggested that specific personality traits and specific conflicts may create particular psychosomatic illnesses, but it is generally believed that the form a disorder takes is due to individual vulnerabilities. Emotional stress is assumed to aggravate existing illnesses, and there is some evidence that it may precipitate illnesses not usually considered to be psychosomatic (e.g., cancer, diabetes) in individuals predisposed to them. Psychosomatic disorders resulting from stress may include hypertension, respiratory ailments, gastrointestinal disturbances, migraine and tension headaches, pelvic pain, impotence, frigidity, dermatitis, and ulcers. Many patients suffering from psychosomatic diseases respond to a combination of drug therapy, psychoanalysis, and behaviour therapy. In less severe cases, patients can learn to manage stress without drugs. See also stress.