Antecedents to Somatoform Disorders: A Pre- and Perinatal Psychology Hypothesis
Publication Date:March 1999
The somatofonn cluster of behavioral disorders is the single most frequent class of unexplainable problems found in primary care medical settings today. What is known about these disorders is that there are physiological, social, and psychological variables that need to be considered. What is not known is how a person develops a propensity toward having physical symptoms as their primary complaint. The author suggests that human beings are classically conditioned when faced with intolerable emotional experiences in the womb or during birth. The residual feelings are laid down in the developing brain's neural pathways in an adaptative strategy of escape and avoidance (focusing on the body instead of the feelings), allowing the organism to survive.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.Bauer, P. J. (1996). What do infants recall of their lives? Memory for specific events by one- and two-year-olds. American Psychologist, 51(1), 29-41.Behavioral Science Task Force of the National Advisory Mental Health Council (1995). Basic Behavioral Science Research for Mental Health: A National Investment: Emotion and Motivation. American Psychologist, 50(10), 838-845.Benoliel, J. (1995). Multiple meanings of pain and complexities of pain management. Nursing Clinics of North America, 30(4), 583.Bower, G. H. (1981). Mood and memory. American Psychologist, 31, 129-148.Carlson, N. R. (1994). Physiology of behavior. Boston, MA: Allyn and Bacon.Chaplin, S. L. (1997). Somatization. In W. Tseng & J. Streltzer (Eds.), Culture & psychopathology: A guide to clinical assessment (67-86). New York: Brunner/Mazel.Dominguez, B., Valderrama, P., de los Angeles Meza, M., Perez, S. L., Silva, A., Martinez, G., Mendez, V. M. & Olvera, Y. (1995). The roles of disclosure and emotional reversal in clinical practice. In J.W. Pennebaker (ed.), Emotion, disclosure, & health. Washington, DC: American Psychological Association.Emerson, W. R. (1996). The vulnerable prenate. Pre- and Perinatal Psychology Journal, 10(3), 125-142.Fauman, M. A. (1994). Study Guide to DSM-IV. Washington, D.C.: American Psychiatric Press, Inc.Gatchel, R. J., Baum, A., & Krantz, D. S. (1988). An introduction to health psychology (2 d ed.). New York: McGraw-Hill.Goleman, D. (1995). Emotional Intelligence. New York: Bantam Books.Kessler, R. C., Nelson, C. B., McGonagle, K. A., Lieu, J., Swartz, M., & Blazer, D. G. (1996). Comorbidity of DSM-111-R major depressive disorder in the general population: results from the U. S. National Comorbidity Survey. British Journal of Psychiatry, 169, 17-30.Kirkwood, C. R., Clure, H. R., Brodsky, R., Gould, G. H., Knaak, R., Metcalf, M., & Romeo, S. (1982). The diagnostic content of family practice: 50 most common diagnoses recorded in the WAMI community practices. Journal of Family Practice, 15(3), 485-492.Kirmayer, L. J. & Taillefer, S. (1997). Somatoform disorders. In S. M. Turner, & M. Hersen (Eds.), Adult psychopathology and diagnosis (3d Ed.). New York: John Wiley & Sons, Inc.Lake, F. (1987). Clinical Theology. New York: Crossroad.Lake, F. (1981). Tight Corners in Pastoral Counselling. London: Darton, Longman and Todd.Lang, P. J. (1984). The cognitive psychophysiology of emotion: Fear and anxiety. In A. J. Tuma & J. D. Maser (Ed.), Anxiety and anxiety disorders (pp. 130-170). Hilldale, NJ: Erlbaum.LeDoux, J. (1993). Emotional memory systems in the brain. Behavioral and Brain Research, 58, 24-39.Leventhal, H. (1984). A perceptual-motor theory of emotion. In L. Berkowitz (Ed.), Advances in experimental socialpsychology (pp. 117-182). New York: Academic.Leventhal, H., & Tomarken, R. (1986). Emotion: Today's problems. Annual Review of Psychology, 37, 565-610.Levi, L. (1974). Psychosocial stress and disease: A conceptual model. In E. K. Gunderson & R. H. Rahe (Eds.), Life stress and illness. Springfield, IL: Charles C. Thomas.Mayou, R., Bass, C., & Sharpe, M. (1995). Overview of epidemiology, classification, and etiology. In R. Mayou, C. Bass & M. Sharpe (Eds.), Treatment of functional somatic symptoms (pp. 42-65). Oxford: Oxford University Press.Miranda, J., Perez-Stable, E., Munoz, R., Hargreaves, W., & Henke, C. (1991). Somatization, psychiatric disorder, and stress in utilization of ambulatory medical services. Health Psychology, 10, 46-51.Nesse, R. M., & Williams, G. C. (1994). Why we get sick. - The new science of Darwinian Medicine. New York: Vintage Books.Reid, W. H., Balls, G. U. & Sutton, B. J. (1997). The treatment of psychiatric disorders (3rd ed.). Bristol, PA: Brunner/Mazel, Inc.Riedlinger, T., & Riedlinger, J. (1986). Taking birth trauma seriously. Medical Hypotheses, 19, 15-25.Schore, A. N. (1994). Affect regulation and the origin of the self. The neurobiology of emotional development. Hillsdale, New Jersey: Lawrence Erlbaum Associates.Terr, L. C. (1988). What happens to early memories of trauma? Journal of the American Academy of Child and Adolescent Psychiatry, 1, 96-104.Thayer, R. E. (1989). The biopsychology of mood and arousal. New York: Oxford University Press.van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253-265.van der Kolk, B. A. (1989). The compulsion to repeat the trauma: Re-enactment, re-victimization and masochism. Psychiatric Clinics of North America. June, vol. 12, 389-411.Bobbi J. Lyman, M.A.Bobbi J. Lyman, M.A., is a Clinical Psychology Doctoral Student at the The Fielding Institute. She may be contacted at 3202 Pine Road, Bremerton, WA 98310.Email: firstname.lastname@example.org