Word: forded
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Dates: during 1980-1989
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According to Ford, somatizing disorders take many forms, including hysteria, malingering, chronic pain and hypochondriasis. The hypochondriac is preoccupied with the fear of having a serious disease. Some doctors refer to the treatment of hypochondriacs, or "crocks," as "psychoceramic medicine" and the recitation of their histories as "organ recitals." Other somatizers sometimes deliberately fake illness, going so far, for example, as to rub a thermometer on a bedsheet to produce a fever, lacerate the skin to create lesions, or overuse laxatives to disrupt the gastrointestinal tract. In the bizarre Munchausen syndrome, which, according to one estimate, affects...
...Ford estimates conservatively that 10% of the patients seen by internists and family practitioners have no physical basis for their ailments. Some doctors, he says, put their case loads of somatizers as high as 40%. Even the low figure, says Ford, means that $20 billion a year in medical care is spent on people with no organic disease...
Part of the problem in dealing with somatizers, notes Ford, is that "physicians on the whole have no training in the identification, diagnosis and treatment of these patients. Typically, the patient's complaint is taken at face value." Physical test after test follows with uniformly negative findings, though, warns Ford, "enough tests and, sooner or later, the patient will have a real disease caused by the process of diagnosing and treating." Doctors must be taught to recognize the hidden meaning behind many physical complaints, says Ford: "It's like two languages being spoken...
...another factor in the poor handling of somatizers, he suggests, is that these patients tap into the physicians' own conflicts. Doctors, Ford argues, see a reflection of themselves in their somatizing patients. Citing studies, plus his own research, he says that many doctors and many somatizers tend to be emotionally inhibited, with high rates of sexual and marital difficulties and a high incidence of drug abuse. As children, both groups frequently lacked close, affectionate relationships with their parents. Their childhoods were commonly marked by a death or serious illness in the family that left them with anxieties about disease...
Faced with somatizing patients, says Ford, physicians are uncomfortably reminded, often unconsciously, of their own inadequacies. As a result, a doctor may reject a patient outright. For example, a physician who is depressed and abusing liquor will tend to shy away from a patient who is an alcoholic. Conversely, the doctor may become overly solicitous, a tactic that backfires. Ford believes the words "You're fine; come back and see me if something develops" are a virtual invitation to create new symptoms...