Psychosomatic therapy, also known as somatic experiencing therapy, is a pioneering approach to liberating individuals from the physical and psychological symptoms of stress, pain, shock, and trauma by addressing their underlying causes. This therapeutic process is rooted in understanding that trauma is not only located in the event itself but can also be found within the body's own systems.
Background and Principles
The concept of psychosomatic therapy originated in the late 1980s, primarily due to the work of Dr. Levine, a psychiatrist who recognized the importance of the body's role in psychological distress. He introduced the term 'trauma in the body, not in the event', emphasizing that it is the body's own physiological responses to challenges that lead to persistent symptoms. Psychosomatic therapy is based on the psychobiological principles of measurement of the nervous system and a keen clinical understanding of how the human organism functions.
Therapy Approach
Psychosomatic therapy is conducted through a series of multi-component, tailored interventions that aim to empower patients by gaining insights into the interactions between their somatic complaints, beliefs, anxiety, concerns, illness behavior, and social environment. Therapists work closely with patients to explore somatic symptoms and integrate the physical, cognitive, emotional, behavioral, and social dimensions of these symptoms to gain a deeper understanding.
Treatment Elements
The core elements of psychosomatic therapy include psycho-education, relaxation techniques, mindfulness, cognitive approaches, and/or graded activity. This holistic approach旨在帮助 patients regain control over their own health by fostering self-regulated ability and monitoring on behavioral change.
Efficacy and Outcomes
Multiple studies have shown that psychosomatic therapy is effective in reducing pain, fatigue, and improving physical functioning and quality of life in patients with medically unexplained symptoms (MUS). A recent systematic review and meta-analysis of published controlled trials found that psychological therapies, specifically cognitive behavioral therapy (CBT), were superior to usual care or waiting list controls in reducing symptom severity in patients with MUS [1]. Additionally, a pilot randomized trial conducted by van Ravensberg and van Berkel in 2019 demonstrated that psychosomatic therapy resulted in statistically significant and Clinically relevant improvements in patients' self-rated symptom severity, somatisation symptoms, hyperventilation symptoms, quality of life, level of functioning, sick leave, and medication use [2].
Study Design
This study aims to establish the cost-effectiveness of psychosomatic therapy for patients frequently attending primary care with MUS. A pragmatic randomised effectiveness trial will be conducted with an economic evaluation. Patients aged 18 years and older who frequently consult their general practitioner (GP) with MUS will be randomly assigned to either receive psychosomatic therapy in addition to usual care or receive usual care alone. The treatment consists of six to 12 sessions of psycho-education, relaxation techniques, mindfulness, and cognitive-behavioral approaches, delivered by a qualified psychosomatic therapist.
##Psychosomatic therapy represents a significant advancement in the treatment of patients with MUS. By targeting the root causes of their symptoms rather than just addressing the symptoms themselves, psychosomatic therapy holds promise for providing more effective and sustainable relief from persistent symptoms. The success of this treatment approach will depend on the ability of therapists to create a therapeutic alliance with patients and to find common ground regarding the causes of the symptoms.
References
[1] Den Boeft M, Twisk JWR, Hoekstra T, et al. Medically unexplained physical symptoms and work functioning over 2 years: their association and the influence of depressive and anxiety disorders and job characteristics. BMC Fam Pract. 2016;17(46):46. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
[2] van Ravensberg CE, van Berkel DJ. patients oriented research into the effects of psychosomatic exercise therapy. (In Dutch). Amersfoort: Nederlands Paramedisch Instituut (NPi); 2010.
[3] Verhaak PF, Meijer SA, Visser AP, et al. Persistent Presentation of medically unexplained symptoms in general practice. Fam Pract 2006;23:414-20. [PubMed] [CrossRef] [Google Scholar]
