This morning I got a note from our member "Trach" that may be of concern to many members. He pointed out an article in Psychology Today which indicates the American Psychiatric Association is well on its way to committing malpractice against each and every one of us. The APA will publish a new version of its Diagnostic and Statistical Manual in March of this year. The DSM working group which deals with psychosomatic medicine has proposed to combine and broaden definitions of so-called "Somatic Symptom Disorder" to such a degree that anyone with an unexplained pain disorder and depression could be written off as a head case and refused effective medical therapy.
The magazine "Psychology Today" published an article in December by the MD who heads up this DSM working group -- and who clearly disagrees with its conclusions. The article is MIND BLOWING for revealing the arrogance and misinformation which prevails within the APA. In response to that article and a related BLOG on health which is maintained by Psychology Today, I have posted the following public comment in your behalf.
I write as an 18-year patient advocate and online researcher who has corresponded with over 4,000 chronic facial pain patients, family members and physicians. I was webmaster and a member of the Board for the US Trigeminal Neuralgia Association in the late 1990s. I now moderate and write content for "Living With TN", a peer-to-peer social networking website affiliated with the Ben's Friends community for rare disorders, serving 3500 members world wide.
Mine was one of many inputs offered to the APA last year through their public commentary gateway on the DSM-V. I was among those urging outright abolishing of the category of the DSM pertaining to so-called "conversion disorder", and other theorized somatic mental disorders. My grounds for this position were that (as far as I know from years of searching) there is no body of validated observational data which confirms the existence or character of any such category of mental disease. NONE!
While pain and depression are often co-morbid in chronic pain patients, I have seen no body of evidence that supports the existence of any such medical entity as so-called "psychogenic pain". I speculate that depression is very often a natural side effect of the fatigue generated by agony -- and of being dismissed and marginalized both by medical doctors and by the people in one's life upon whom we most often rely for emotional support.
With these concerns in mind, I have circulated the following note to a wide circle of professional friends and colleagues"
The American Psychiatric Association seems to be on the brink of making a disastrous ethical and medical error. It is about to validate a psychiatric mythology as real, enabling the dismissal or mistreatment of potentially hundreds of thousands of medical patients who have complex or ill-understood pain disorders. I urge any of you who are affiliated with professional communities, to please read and pass on the following article, as well as the blog link at its end. And I urge those of you who are licensed practitioners, to advocate for immediate action by your own professional associations, to stop this atrocity in its tracks.
Richard A. Lawhern, Ph.D.
Moderator, "Living With TN"
Thank you so much for advocating for us Red! You are our rock and I don't know what we would do without you!
They don't need to revise the DSM to write off chronic pain patients as "psych cases," they often do it now anyway and many medical doctors are complicit in the madness. BTW, they are getting more sophisticated with this. One psychiatrist told me that Freud is out and Pavlov is in when it comes to "somatoform disorder." Its not so much that the patient is converting psycho-social stress to physical symptoms through some mysterious process nobody can define, its that the pain centers of your brain become activated due to emotional stress and get "stuck in the on position." If that is where it ended, they may not be doing badly. But old habits die hard, and this is usually followed by talk of "sickness behaviours," "sickness roles," and "enabling family members" as the reason why people with chronic pain can't recover.
Kismet, you ask the perfect question. My suggestion is that as many of us as possible read the article and leave comments in the public BLOG of Psychology Today, reporting our own experiences of having been "somaticized", marginalized, and dismissed. Their ability to influence others in profession is supported by the numbers of people who register their own mistreatment by medical professionals who have labeled them head cases.
Regards and best,
Check out the Mayo Clinic's approach to chronic pain patients. Their approach: go to a three week long "rehabilitation program," involving cognitive behavioral therapy, graded exercise therapy, stress management and bio-feedback. Its basically the approach to "chronic fatigue syndrome" and fibromyalgia championed by the British psychiatrist Simon Wesley, for whom these syndromes are mostly about poor coping skills.
Although Mayo Clinic may have it's collective head up its collective behind concerning issues of somatization, I think we need to maintain some moral balance concerning the tools it applies. Cognitive Behavioral Therapy has a record of positive results in helping patients to manage and overcome post-traumatic stress disorder. Many TN patients report feeling like they've been traumatized by the medical community as well as by the disorder. We also know that stress and emotional trauma interact with and facilitate breakthrough pain.
So I would caution all of us not to throw out the baby with the bath water, despite the stink of hypocrisy that we detect in the bath. When psychological therapy or awareness training gives patients better self-empowerment, lower stress and greater calm, I believe such supports can be constructive and useful.
Go in Peace and Poiwer
my neurologist told me this has happened to me because of my anxiety disorder I WOULD NEVER DO THIS TO MYSELF!! i knew right then i was in the wrong place and if i hadn't already known that because of this website i would have blamed it on myself.. Thanku so much for sticking up for us!!
Kari, you analogy is spot on. What a shame we don't have a reply platform. As you know many members here DO think some Dr's are nutjobs! By the criteria set out above we All qualify as somatic very worrying. Surely it is obvious to almost anyone that extreme pain will induce extreme behavior in some of us, and yet we are still sane and genuinely do have TN!!!!!!!!!!!!!!!!!!!!!!!!!!!
Nomad, I am sorry to read about your sad losses. And Dr abuse. Let's not forget, we cannot treat ourselves and we rely on these people to HELP us. Our rare illness causes a lot of stress, yet we may be labelled as Somatic! Really, where do these idiots get off????????????????
What about Dr's with severe pain etc. are they to be labelled somatic?????????????? No, they will be treated well and helped immensely ! I am very cross now Grrrrrrrrrrrrrrrrrrrrr!