Psych-Talk with Dr. Mike: If it hurts, is it real?

Dr. Mike Gropper, psychotherapist and marital therapist specializing in clinical diagnosis and therapy, looks at psychosomatic illness.

Dr. Mike Gropper is an American psychotherapist and marital therapist living in Ra'anana. For further details, see end of story. Woody Allen, the noted actor-writer comedian and perhaps the most famous on-screen hypochondriac, was once asked in an interview whether he was a real life hypochondriac, to which he responded in the negative. "I'm an alarmist, which is a completely different problem," he said. "I do not imagine that I get illnesses, but should I wake up one morning with chapped lips, I think I have cancer. I go right to the worst possible permutation on something." Perhaps we laugh at Allen's neurotic on-screen characters because in each of us there is a bit of the "neurotic" worrier. Approximately 60% of people's emotional problems are not directed at a psychotherapist, but show up in their family doctor's office as some type of a physical complaint such as a headache, fatigue, lightheadedness or lower back pain, or a multiplicity of aches and pains that easily mimic more serious illness. Doctors call these complaints "functional," "psychosomatic," or "somatization" because the symptoms are not explained by medical tests, but are a result of emotional stress and psychosocial pressures. Most physicians are not trained to detect emotional stress and the to see patients at a fairly quick rate (10 minutes on average) doesn't give time to understand what is really bothering their patients on an emotional level. Often the patient must go the route of tests and specialists who come up emptyhanded. How do our feelings find their way to physical expression? If we look at our bodies as containers, we can begin to make some sense out of why and how people "somatize" their emotions. Besides containing food and our organs, the body acts as a big backup system for feelings, fears, anxieties, and worries. When feels tense or stressed out, they can usually identify which parts of their body feels tense or is in pain. Most people know that their emotions can affect the way they feel, but don't recognize to what extent their feelings, when not acknowledged or properly released and dealt with, can impose major physical harm and suffering. There are also many who, as a result of traumatic experiences in their lives (emotional and/or physical abuse while growing up, or being the victim of a terror act) have learned not to allow themselves to feel their feelings. These individuals have had to put their feelings on hold, hide them and get them, so to speak, out of sight and mind. Psychologists use the terms "disassociate" or "depersonalize" to describe such a severe attempt to remove oneself from unpleasant and overwhelming emotional states. Unfortunately, emotions that are not acknowledged find their way to express themselves, if not in feelings, than in physical ways. Many medical symptoms and conditions are brought about by stress, or affected by our feelings. In my psychotherapy practice, as many as 50 percent of the presenting complaints begin as a physical symptom or in some fashion have a powerful physical component. Examples are chronic migraines, asthma attacks, chest pains, ulcers, fatigue, digestive problems, lowered sexual interest, lower back pain, stuttering, aches and pains, general bad ill feelings the list goes on. Mark's chronic fatigue Mark, a hi-tech programmer in his early 30s, had been feeling run down for nearly four months. He also had many general body complaints. At one point, his physician believed that Mark was suffering from Epstein-Bar Disease, a virus that would just run its course and eventually Mark would feel better. However, blood tests and physical exam did not verify this suspicion. Went Mark went for therapy it turned out that Mark's wife was extremely demanding and expected him to take care of all of the household chores, cook, and share in the care of their four children, besides working. Mark had no idea how angry he had become in his marriage. As therapy progressed, Mark was able to begin to understand his anger and to demand that his wife take on more responsibility. Mark began exercising and worked on learning to identify his anger earlier instead of holding his feelings inside, eventually all fatigue symptoms disappeared. Robin's chronic back problems Robin, age 32, had been married for two years and had a three-month-old baby. Yacov, her husband, grew up in a family with a domineering mother and very weak and passive father. His mother demanded complete submission and constant help. His dad, who suffered from depression, was often unemployed and a poor economic provider. Yacov often had to hold jobs working long hours even when he attended school and he rarely had any time for his own social life or friends. Robin was finding her marriage to Yacov loaded with problems, especially his passivity and lack of initiative to help out with household chores. Robin, exhausted by carrying the entire burden, developed an excruciating and nagging back pain that her physician stated was stress-related. She was referred to therapy. Robin's therapy led to couple therapy and what emerged was clearly a picture of Robin's resentment towards her husband for putting all of the responsibilities on her. She felt that she could no longer bear the weight of doing everything by herself and she started to cry. Yacov was helped to change his pattern and begin to take on more responsibility in the home, even to the point of initiating actions, which pleased his wife very much. At this point her backache simply disappeared. Dr. Mike Gropper is an American trained psychotherapist and marital therapist specializing in clinical diagnosis and therapy for both children and adults. He is a clinical consultant to the Jewish Board of Family and Children's Services and Mt Sinai Medical Center in NYC and the Institute for the Advancement of Children in Israel. He has been on the faculty of the Bar Ilan University and Haifa University Schools of Social Work and the Mount Sinai Medical Center in NYC. He is also the founder and director of SmokeQuitters (, a smoke cessation treatment program. His office is located at the Golan Center, Achuza 198 in Ra'anana, (09) 774 1913, Send your comments >> * * * Cafe Oleh experts have been chosen for their knowledge and reputation. 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