Somatization is a phenomenon that poses a tremendous challenge for patients and physicians alike. No health problem raises more confusion, anxiety, frustration and helplessness than distressing physical symptoms, such as pain or fatigue, which doctors are unable to explain. A phenomenological-hermeneutic investigation was therefore conducted to better understand this mysterious phenomenon and to determine why the Western health care system has such difficulty understanding and treating somatizing patients who suffer from medically unexplained physical symptoms. It was hypothesized that flawed philosophical, theoretical and/or methodological assumptions are partially at fault. As such foundational assumptions are implicit and taken-for-granted their validity is rarely questioned, yet their implications for treatment are profound. To explore this hypothesis, four models of somatization were reviewed and critically evaluated to identify how their foundational assumptions may be contributing to or impeding progress in the conceptualization and treatment of somatization. These include the neuropsychiatric, biopsychosocial, psychoanalytic and narrative models of somatization. After outlining the foundations of a phenomenological-hermeneutic approach, the models of somatization were presented, along with a description of how the symptoms of a particular clinical case would likely be conceptualized. Each model was then evaluated in three stages: (1) explication of foundational assumptions, (2) evaluation of strengths and weaknesses, and (3) implications for the problematic of somatization. As a result of this evaluation, specific foundational assumptions have been identified which interfere with the ability of certain models to adequately capture the richness and complexity of somatization as it is lived and experienced by individual sufferers. These flawed foundational assumptions result in inaccurate or incomplete conceptualizations which hinder the ability of proponents to design effective treatments. As a result, some models are contributing inadvertently to the suffering experienced by their patients. While the models varied significantly in terms of their strengths and weaknesses, a cross-model comparison identified a number of foundational, conceptual and treatment issues that remain unresolved or inadequately addressed by the models as a whole. The final chapter described how a phenomenological-hermeneutic approach can begin to address these issues and provide a novel contribution to the understanding and treatment of somatization.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/6446 |
| Date | January 2002 |
| Creators | de Laplante, Lori Teresa. |
| Contributors | Mook, Bertha, |
| Publisher | University of Ottawa (Canada) |
| Source Sets | Université d’Ottawa |
| Detected Language | English |
| Type | Thesis |
| Format | 245 p. |
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