The idea that Fibromyalgia (FM) is a psychosomatic disorder triggered by physical or emotional abuse has long been the focus of research. Recently, the International Review of Psychiatry (IRP) has published an overview of research on the treatment of Fibromyalgia (FM) from a psychosomatic perspective.
The term ‘psychosomatic’ is an emotive one which is prone to misunderstanding and, as a result, is often misused. What it certainly doesn’t mean is ‘all in the mind’, ‘swinging the lead’, ‘hypochondriac’, ‘imaginary illness’ or any of the other myriad of terms applied colloquially to conditions where, in full or in part, there may be no clear physical cause for the presenting symptoms.
Psychosomatic means mind (psyche) and body (soma), so a psychosomatic condition is one where psychological factors such as stress, anxiety and depression give rise (or significantly contribute) to the development and maintenance of physical symptoms. These symptoms are not imagined; they are very real, but however they manifest, treatment will to a major extent lie in the field of psychological medicine.
Is Fibromyalgia a psychosomatic condition?
On its website, the NHS lists “stress” as one of a number of possible causes or contributory factors to developing FM, others being abnormal pain messages, chemical imbalances in the brain, a disturbed sleep pattern and simple genetics. However, it is also keen to stress that “in some cases, fibromyalgia doesn’t develop after any obvious trigger.” And that is the point; nobody really knows for sure what causes FM.
What psychological treatment is offered to FM sufferers?
Like most chronic pain conditions, the approach to treating FM is multimodal, but there is usually a significant psychiatric/psychological component to treatment. This usually comprises medication, particularly antidepressants, and Cognitive Behavioural Therapy (CBT). A 2010 analysis of psychological treatments for fibromyalgia concluded that CBT was the most effective.
The research overview
Researchers collected evidence published in the last 10 years which concerned the management of FM from a psychosomatic perspective. Having considered this evidence they strongly emphasised the importance of both considering and treating associated psychological conditions in conjunction with other factors affecting pain management in those suffering FM.
Interestingly, other recent studies have identified higher rates of psychological conditions, including PTSD, anxiety and depression, in FM sufferers than in those suffering rheumatoid arthritis, which seems to give at least some credence to the involvement of psychological factors in the onset of FM. However, the current evidence suggests that it would be a huge oversimplification to say that other (non-psychological) factors were not also involved.