Traumatiska upplevelser som inte bearbetas kan ge somatiska symtom, i en del fall som uttryck för dissociation, så kallade somatoforma dissociationer. Patienter med dessa symtom söker sig till sjukvården där bristande kunskap om symtom på trauma kan fördröja adekvat behandling. Studiens syfte är undersöka traumainriktade terapeuters erfarenheter av arbete med patienter som har somatoforma dissociationer. Frågeställningarna är: Vilka upplevelser har psykoterapeuter av affektreglering och allians med traumatiserade patienter? Vilka symtom i form av somatoforma dissociationer ses hos patienterna? Hur kan man fånga upp traumarelaterad problematik inom sjukvården? Metoden är en kvalitativ undersökning i form av intervjuer med fem legitimerade psykoterapeuter som arbetar på traumamottagningar. Resultatet visar att somatiska symtom är vanliga hos traumatiserade patienter och att en del av symtomen kan betraktas vara somatoforma dissociationer. De somatiska symtomen kan ses som ett uttryck för obearbetade affekter och affektreglering är en väg till minskning av symtomen. I psykoterapin är tilliten en viktig del i alliansen. Slutsatser som kan dras är att somatoforma dissociationer kan behöva lyftas fram för att tydliggöra de somatiska uttryckens koppling till trauma. Inom sjukvården är det av vikt med ökad kunskap kring trauma så att patienten även får hjälp till affektreglering genom terapi och inte endast t ex fortsatt medicinsk behandling för somatiska och psykiska symtom. / Experiences of trauma that not are taken care of may give somatic symptoms, in some cases as signs of dissociation, so called somatoform dissociations. Patients with these symptoms search for help in the medical care where insufficient knowledge of trauma symptoms can delay adequate treatment. The aim of this study is to investigate therapists’ experiences of therapy with traumatized patients that have somatoform dissociations. The questions to be asked are: Which experiences do psychotherapists have of affect regulation and alliance with traumatized patients? Which symptoms do patients have that can be seen as somatoform dissociations? How can you be aware of trauma related problems in the medical care? The method is a qualitative approach based on interviews of five legitimated psychotherapists working with traumatized patients. The result shows that somatic symptoms are common in traumatized patients and that some symptoms can be seen as somatoform dissociations. The somatic symptoms can be seen as signs of unprocessed affects and affect regulation is a way to reduce the symptoms. In psychotherapy faith is an important part of the alliance. Derived conclusions are that somatoform dissociations need to be highlighted so that the link between somatic symptoms and dissociation can be clarified. In the medical care the knowledge of trauma is essential so that the patient also gets help with affect regulation and not only further medical treatment of somatic and psychological symptoms.

There is a paucity of research on the diagnosis of dissociative disorders in children. Most children are misdiagnosed with more common mental disorders with similar symptoms. Earlier recognition of dissociative disorders can save years of pain, suffering, and cost. This qualitative collective case study examined the process of diagnosing dissociation in two children under the ages of 12 at the beginning of treatment. A concurrent focus on the training and development of the therapist/researcher is included. Archival data including progress notes, psychotherapy notes, assessments, correspondence, legal documents, school records, and medical records were analyzed using within-case and cross-case analyses to identify individual and common themes that may expedite the diagnosis of dissociative disorders in children. The narrative presentation of a qualitative study with its thick, rich description may increase the understanding of clinicians with little or no experience and help them to differentiate these disorders from other disorders with overlapping symptoms. Factors that impeded and advanced the recognition of dissociative disorders were identified. Clinical findings underscore the role of knowledge and training, experience, and consultation in the diagnosis of dissociative disorders.

Endometriosis is defined as the presence of endometrial cells outside the uterine cavity. The underlying symptom is pain, endometriosis is often associated with primary or secondary sterility, and it is assumed to be involved in the development of female dyspareunia and algopareunia. There are many theories regarding the cause of the disease, however, none of them affects the complex state of the disease which occurs in the population according to statistics in 10-15 % of women. In women with a diagnosis of sterility and infertility, the incidence of endometriosis is described in more than 40 %. Also, more than 50 % of women describe the most diverse forms of dyspareunia and algopareunia that affect not only women's own lives but also their relationships. The illness thus becomes important not only from a purely medical point of view but also from a psychosocial point of view. It should be noted that there is currently no known specific laboratory marker to diagnose endometriosis. Likewise, there is no unambiguous solution within the therapy, whether it is conservative, surgical, or combined. An important fact is that endometriosis is diagnosed with a considerable delay, according to statistics; it takes up to 11 years from the discovery of the first, often indefinite symptoms, to the unequivocal...