A diagnosis of psychosomatic illness should not be made lightly. Firstly, the possibility of any organic illness must be ruled out. (Organic in this sense means ‘of the body’, and organic illness includes infections, autoimmune disorders, allergies and other problems with an identifiable cause.) Even if all organic diseases have been ruled out, there are still other criteria to satisfy. The patient should have the right sort of symptoms and should have been subject to some stressful emotional experience before the onset of the illness. A typical pattern in psychosomatic illness is for the disease to fluctuate with periods when the symptoms disappear only to return again at a later date. If this pattern is present, and if other members of the family have had psychosomatic complaints, then the diagnosis is strengthened.
Unfortunately, a diagnosis of psychosomatic illness is often arrived at by a much shorter and less strenuous route than this, particularly with female patients, who tend to be perceived as more ‘nervy’. All too often, doctors use ‘psychosomatic’ as a diagnosis of convenience, to cover any illness with no obvious cause. What is more, little is offered in the way of treatment. This is paradoxical because physical illness is taken seriously and given adequate treatment, arid mental illness with mainly mental symptoms is taken seriously and treated (if not always very effectively or humanely). For some reason, mental illness that produces physical symptoms is relegated to the status of an ‘imaginary’ disease.
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