Short-Term Strategic Treatment in Traumatic Conversion Reactions
Examples of other psychogenic disorders are other conversion disorders, such as psychogenic blindness, paralysis, and so on; and somatization disorders, which involve multiple, psychologically caused physical symptoms. For the former, the "deceptive treatment" may involve a paradoxical strategy, such as instructing patients to "do deliberately what they believe to be occurring involuntarily." N. Dough and E. Witztum, "Short-Term Strategic Treatment in Traumatic Conversion Reactions," American Journal of Psychotherapy 45 (1991): 335-47, at 336. For the latter, the deceptive treatment may involve offering patients "time-limited ... visits independent of physical symptoms."
Educating the public may be possible over time. See C. Bass and S. Benjamin, "The Management of Chronic Somatisation," British Journal of Psychiatry 162 (1993): 472-80, at 478-89.
This risk also exists far outside these kinds of situations, and occurs whenever careproviders engage in deceit, even by omission. For example, a dermatologist excised a mole from a patient's chest, and said that the mole could be benign or malignant. Only after it was found to be benign did the doctor inform the patient that malignancies are more common in moles in this area. The doctor had withheld information about the greater risk.
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Challenges of Somatization: Diagnostic, Therapeutic and Economic
"Most physicians are . . . symptom-oriented . . . and not psychosocial in their . . . approach. Somatizing patients seen by them are reported to be over-studied, underdiagnosed, undertreated, needlessly hospitalized, and costly over-utilizers of the heath care system." D.R. Lipsitt, "Challenges of Somatization: Diagnostic, Therapeutic and Economic, Psychiatric Medicine 10 (1992): 1-12, at 4.
Assisting careproviders to overcome these feelings may be exceedingly difficult. See R.J. Goldberg et al., "The Recognition and Management of Somatization," Psychosomatics 33 (1992): 55-61, at 58-59.
