https://doi.org/10.4081/ripppo.2023.605
A theoretical and clinical perspective of an embodied view in psychotherapy of somatic symptoms disorders
Submitted: December 29, 2021
Accepted: April 26, 2023
Published: August 25, 2023
Accepted: April 26, 2023
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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In this paper, we offer some ideas for the treatment of somatoform patients and related pathologies based on the concept of embodiment. Embodiment refers to the interplay between body and mind in behavior. The word refers to giving a body to something, “incarnate”. Spinoza wrote extensively about the topic in the 17th century. In the 20th century, picking up on Spinoza’s work, Damasio presented extensive and important neuro-scientific evidence that feelings can be direct perceptions of internal body states, substantiating the growing understanding of emotions and feelings as a core component of the embodied experience. Here, we summarize the evidence for the intersection of emotion and cognition in the body, which impinges on the effectiveness of using the body and movement in psychotherapy and the management of somatic symptoms and related disorders. We present evidence indicating that movement would be a way to reach unconscious processes dealing with body-mind interaction and body awareness.
Abey, S. E. (2005). Somatization and somatoform disorders. In James, L. (ed.), Textbook of psychosomatic medicine. Washington, The American Psychiatric Publishing. pp. 271-296.
Brown, R. (2004). Psychological mechanisms of medically unexplained symptoms and integrative conceptual model. Psychological Bulletin, 130(5), 793-821. doi: 10.1037/0033-2909.130.5.793.
DOI: https://doi.org/10.1037/0033-2909.130.5.793
Bucci, W. (1997). Symptoms and symbols: a multiple code theory of somatization. Psychoanalytic Inquiry, 17(N2), 151-172.
DOI: https://doi.org/10.1080/07351699709534117
Bucci, W. (2020). Emotional communication and therapeutic change: understanding psychotherapy. London, Routledge.
DOI: https://doi.org/10.4324/9781003125143
Burns, C. A. (2012). Embodiment and embedment: integrating dance movement therapy, body psychotherapy and eco-psychology. Body, Movement and Dance in Psychotherapy and Psychiatry, 7(1), 39-54.
DOI: https://doi.org/10.1080/17432979.2011.618513
Damasio, A. (1999). The feeling of what happens: body and emotion in the making of consciousness. New York, Hartcourt Brace.
Damasio, A. (2003). Looking for Spinoza. London, William Heinemann.
Damasio, A., Everitt, B., & Bishop, D. (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical Transactions: Biological Sciences, 351(1346), 1413-1420.
DOI: https://doi.org/10.1098/rstb.1996.0125
Dosamantes-Alperson, E. (1984). Experiential movement psychotherapy. In Lewis, P. (ed.). Theoretical approaches in dance-movement therapy (vol II, p.156). Dubuque, Kendall-Hunt.
Downing, G. (2015). The body and the word in psychotherapy. In: Marlock, G., Weiss, H., Young, C., & Soth, M. (eds.). Handbook of body psychotherapy and somatic psychology. Berkeley, North Atlantic Books.
Duncan, S., & Feldman-Barrett, F. L. (2007). Affect is a form of cognition: a neurobiological analysis. Cognition and Emotion, 21(6), 1184-1211. doi: 10.1080/02699930701437931.
DOI: https://doi.org/10.1080/02699930701437931
Gallese, V. (2009). Mirror neurons embodied simulation and the neural basis of social identification. Psychoanalytical Dialogues, 19(5), 519-536. doi: 10.1080/10481880903231910.
DOI: https://doi.org/10.1080/10481880903231910
Gallese, V., & Sinigaglia, C. (2011). How the body in action shapes the self. Journal of Consciousness Studies, 18(7-8), 17-43.
Henningsen, P., Zipfel, S., & Herzog, W. (2007). Management of functional somatic syndromes. Lancet, 369(9565), 946-955. doi: 10.1016/S0140-6736(07)60159-7.
DOI: https://doi.org/10.1016/S0140-6736(07)60159-7
Henningsen, P., Zipfel, S., Sattel, H., & Creed, F. (2018). Management of functional somatic syndromes and bodily distress. Psychotherapy and Psyhosomatics, 87(1), 12-31. doi: 10.1159/000484413.
DOI: https://doi.org/10.1159/000484413
Hilbert, A., Martin, A., Zech, T., Rauh, E., & Rief, W. (2010). Patients with medical unexplained symptoms and significant others: illness attributions and behaviors as predictors of patients functioning over time. Journal of Psychosomatic Research, 68(3), 253-262.
DOI: https://doi.org/10.1016/j.jpsychores.2009.09.012
Hofer, M. A. (1984). Relationships as regulators: a psycho-biologic perspective on bereavement. Psychosomatic Medicine, 46(3), 183-197.
DOI: https://doi.org/10.1097/00006842-198405000-00001
Kalisvart, H., van Broeckhuysen, S., Bühring, M., Kool, M., van Dulmen, S., & Geenen, R. (2012). Definition and structure of body-relatedness from the perspective of patients with severe somatoform disorder and their therapists. PLoS One, 7(8), e42534. doi: 10.1371/journal.pone.0042534.
DOI: https://doi.org/10.1371/journal.pone.0042534
Kanaan, R. A., Lepine, J. P., & Wessely, S. C. (2007). The association or otherwise of the functional somatic syndromes. Psychosomatic Medicine, 69(9), 855-859. doi: 10.1097/PSY.0b013e31815b001a.
DOI: https://doi.org/10.1097/PSY.0b013e31815b001a
Kanitz, J. L., Moneta, M. E., & Seifert, G. (2013). Keeping the balance: an overview of mind-body therapies in pediatric oncology. Complementary Therapies in Medicine, 21(Suppl 1), S20-S25. doi: 10.1016/j.ctim.2012.02.001.
DOI: https://doi.org/10.1016/j.ctim.2012.02.001
Kirmayer, L. J., & Looper, K. J. (2006). Abnormal illness behavior: physiological, psychological and social dimensions of coping with distress. Current Opinion Psychiatry, 19(1), 54-60. doi: 10.1097/01.yco.0000194810.76096.f2.
DOI: https://doi.org/10.1097/01.yco.0000194810.76096.f2
Knoblauch, S. H. (2011) Contextualizing attunement within the polyrhythmic weave: the psychoanalytic samba. Psychoanalytic Dialogues, 21(4), 414-427. doi: 10.1080/10481885.2011.595322.
DOI: https://doi.org/10.1080/10481885.2011.595322
Lahmann, C., Henningsen, P., Noll-Hussong, M., & Dinkel, A. (2010). Somatoform disorders. Psychotherapie, Psychosomatik, medizinische Psychologie, 60(6), 227-233. doi: 10.1055/s-0030-1248479. [Article in German]
DOI: https://doi.org/10.1055/s-0030-1248479
Landa, A., Peterson, B., & Fallon, B. (2012). Somatoform pain: a developmental theory and translational research review. Psychosomatic Medicine, 74(7), 717-727. doi: 10.1097/PSY.0b013e3182688e8b.
DOI: https://doi.org/10.1097/PSY.0b013e3182688e8b
Lane, R. D. (2008). Neural substrates of implicit and explicit emotional processes: a unifying framework for psychosomatic medicine. Psychosomatic Medicine, 70(2), 214-231. doi: 10.1097/PSY.0b013e3181647e44.
DOI: https://doi.org/10.1097/PSY.0b013e3181647e44
Mancia, M. (2006). Implicit memory and early unrepressed unconscious: their role in the therapeutic process (how the neurosciences can contribute to psychoanalysis). International Journal of Psychoanalysis, 87(Pt 1), 83-103.
DOI: https://doi.org/10.1516/39M7-H9CE-5LQX-YEGY
Maunder, R. G., & Hunter, H. (2001). Attachment and psychosomatic medicine: developmental contributions to stress and disease. Psychosomatic Medicine, 63(4), 556-567. doi: 10.1097/00006842-200107000-00006.
DOI: https://doi.org/10.1097/00006842-200107000-00006
Mayou, R., Kirmayer, L. J., Simon, G., Kroenke, K., & Sharpe, M. (2005). Somatoform disorders: time for a new approach in DSM-V. American Journal Psychiatry, 162(5), 847-855. doi: 10.1176/appi.ajp.162.5.847.
DOI: https://doi.org/10.1176/appi.ajp.162.5.847
Monsen, K., & Monsen, J. (2000). Chronic pain and psychodynamic body therapy: a controlled outcome study. Psychotherapy Theory, Research, Practice, Training, 37(3), 257-269. doi: 10.1037/h0087658.
DOI: https://doi.org/10.1037/h0087658
Nebbiosi, G., & Federici-Nebbiosi, S. (2008). We got rhythm. In Anderson, F. S. (ed.). Bodies in treatment: the unspoken dimension. New York, The Analytic Press.
Paivio, A. (1986). Mental representations: a dual coding approach. Oxford, Oxford University Press.
Panksepp, J. (1998). Affective neurosciences. The foundations of human and animal emotions. Oxford, Oxford University Press.
DOI: https://doi.org/10.1093/oso/9780195096736.001.0001
Porges, S. W. (2009) The poly-vagal theory: new insights into adaptive reactions of autonomic nervous system. Cleveland Clinical Journal Medicine, 76(Suppl 2), S86-S90. doi: 10.3949/ccjm.76.s2.17.
DOI: https://doi.org/10.3949/ccjm.76.s2.17
Rief, W., & Barsky, A. J. (2005). Psychobiological perspective on somatoform disorders. Psychoneuroendocrinology, 30(10), 996-1002. doi: 10.1016/j.psyneuen.2005.03.018.
DOI: https://doi.org/10.1016/j.psyneuen.2005.03.018
Rief, W., & Broadbent, E. (2007). Explaining medically unexplained symptoms-models and mechanisms. Clinical Psychology Reviews, 27(7), 821-841.
DOI: https://doi.org/10.1016/j.cpr.2007.07.005
Rief, W., Hiller, W., & Margraf, J. (1998). Cognitive aspects of hypocondriasis and the somatization syndrome. Journal of Abnormal Psychology, 107(N4), 587-595. doi: 10.1037//0021-843x.107.4.587.
DOI: https://doi.org/10.1037/0021-843X.107.4.587
Russell, J. A. (2003). Core affect and the psychological construction of emotion. Psychological Review, 110(1), 145-172.
DOI: https://doi.org/10.1037/0033-295X.110.1.145
Sayar, K., Gulec, H., & Topbas, M. (2004). Alexithymia and anger in patients with fibromyalgia. Clinical Rheumatology, 23(5), 441-448. doi: 10.1007/s10067-004-0918-3.
DOI: https://doi.org/10.1007/s10067-004-0918-3
Schachter, J., & Kaechele, H. (2010) The couch in psychoanalysis. Contemporary Psychoanalysis, 46(3), 439-459. doi: 10.1080/00107530.2010.10746071.
DOI: https://doi.org/10.1080/00107530.2010.10746071
Schaefert, R., Hausteiner-Wiehle, C., Häuser, W., Ronel, J., Hermann, M., & Henningsen, P. (2012). Non-specific, functional, and somatoform bodily complaints. Deutsches Arzteblatt International, 109(47), 803-813. doi: 10.3238/arztebl.2012.0803.
DOI: https://doi.org/10.3238/arztebl.2012.0803
Shafir, T., Taylor, S. F., Atkinson, P., Langenecker, S. A., & Zubieta J. K. (2013). Emotion regulation through execution, observation, and imagery of emotional movements. Brain and Cognition, 82(2), 219-227. doi: 10.1016/j.bandc.2013.03.001.
DOI: https://doi.org/10.1016/j.bandc.2013.03.001
Shafir, T., Tsachor, R. P., & Welch, K. B. (2016). Emotion regulation through movement: unique sets of movement characteristics are associated with and enhance basic emotions. Frontiers in Psychology, 6, 2030. doi: 10.3389/fpsyg.2015.02030.
DOI: https://doi.org/10.3389/fpsyg.2015.02030
Shore, A. (2011). The right brain implicit self lies at the core of psychoanalysis. Psychoanalytic Dialogues, 21(1), 75-100.
DOI: https://doi.org/10.1080/10481885.2011.545329
Sletvold, J. (2018). The ego and the Id revisited Freud and Damasio on the body/ego self. The International Journal of Psychoanalysis, 94(5), 1019-1032. doi: 10.1111/1745-8315.12097.
DOI: https://doi.org/10.1111/1745-8315.12097
Stern, D. (2004). The present moment in psychotherapy in everyday life. New York, Norton & Company.
Theadom, A., Cropley, M., Smith, H. E., Feigin, V. L., & McPherson, K. (2015). Mind body therapy for fibromyalgia. Cochrane Database of Systematic Reviews, 2015(4), CD001980. doi: 10.1002/14651858.CD001980.pub3.
DOI: https://doi.org/10.1002/14651858.CD001980.pub3
Thieme, K., Flor, H., & Turk, D. (2006). Psychological pain treatment in fibromyalgia syndrome: efficacy of operant behavioral treatments. Arthritis Research Therapy, 8(4), R121. doi: 10.1186/ar2010.
DOI: https://doi.org/10.1186/ar2010
Van de Bergh, O., Witthoft, M., Petersein, S., & Brown, R. (2017). Symptoms and the body: taking the inferential leap. Neurosciences and Biobehavioral Review, 74(Pt A), 185-203. doi: 10.1016/j.neubiorev.2017.01.015.
DOI: https://doi.org/10.1016/j.neubiorev.2017.01.015
Van der Feltz-Cornelis, C. M., van Houdenhove, B. (2014). DSM-5: from 'somatoform disorders' to 'somatic symptom and related disorders'. Tijdschr Psychiatrie, 56(3), 182-186.
Varela, F. J., Thompson, E., & Rosch. E. (1991). The embodied mind: cognitive sciences and human experience. Cambridge, The MIT Press.
DOI: https://doi.org/10.7551/mitpress/6730.001.0001
Walker, E. A., Uhutzer, J., & Katon, W. J. (1998). Understanding caring for the distressed patient with multiple medically unexplained symptoms. Journal American Board Family Practice, 11(5), 347-356. doi: 10.3122/15572625-11-5-347.
DOI: https://doi.org/10.3122/15572625-11-5-347
Waller, E., & Scheidt C. (2006). Somatoform disorders as disorders of affect regulation: a development perspective. International Review Psychiatry, 18(1), 13-24. doi: 10.1080/09540260500466774.
DOI: https://doi.org/10.1080/09540260500466774
Yunus, M. B. (2012). The prevalence of fibromyalgia in other chronic pain conditions. Pain Research Treatment, 2012, 584573. doi: 10.1155/2012/584573.
DOI: https://doi.org/10.1155/2012/584573
How to Cite
Moneta, M. E., & Kaechele, H. (2023). A theoretical and clinical perspective of an embodied view in psychotherapy of somatic symptoms disorders. Research in Psychotherapy: Psychopathology, Process and Outcome, 26(2). https://doi.org/10.4081/ripppo.2023.605
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