Michael Eriksson
A Swede in Germany
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The odd misconception of a problem “in the head”

On many occasions I have come across (in e.g. articles) the situation that someone goes to a physician to complain about a problem, is told that there is nothing physically wrong with her (more rarely, him) and that the problem is in her head—whereupon she feels mistreated, not taken seriously, and tries to find support for a physical problem elsewhere. Notwithstanding the possibility of a misdiagnosis, this has long puzzled me. Apparently there is some prejudice against psychosomatic (and similar) problems.

The main problem seems to be that the patient (not the physician!) sees the diagnosis as “you do not have a real problem”. This is entirely irrational: The symptoms remain the same irrespective of their reason, and it is well established that the mind can affect the body in various ways. The difference eventually lies in the treatment, not the symptoms. In particular, if an ordinary physician wants to remit the patient to a psychiatrist, then this is just common sense—not an attempt to pawn off a patient. Similarly, it is just common sense for a general practitioner to send a patient with a heart problem to a cardiologist.

Of course, it could be that psychological problems of various kinds carry a greater stigma than do physical problems; however, this too is irrational. Most psychological problems, just like most physical problems, are caused by external circumstances. There is no greater shame in a “sprained mind” than in a sprained ankle. Most importantly: Poor psychological health is just as prevalent as poor physical health—with the regrettable difference that most people fail to get help they would benefit from where their minds are concerned. Make no mistake: For every couch-potato, sufferer from the common cold, cancer patient, shot knee, angina case, ... there is another person with a corresponding mental issue. In particular, do not be naive as to your own mental health—the probability that you are perfect in this regard is just as low as the probability of physical perfection. We are all mentally (and physically) in-sane (unhealthy) to a greater or lesser degree—only a regrettable minority is actually insane (coo-coo).

More generally, there seems to a strong tendency in society to find physical explanations for problems that manifest physically—without wanting to recognize the possibility of a psychological explanation Consider Electromagnetic_hypersensitivityw: The accumulated time I have spent in front of computers counts in years; individual weeks where I top out at eighty hours have occurred. In addition, I have had typical exposures to televisions, cell-phones, the usual electromagnetic fields occurring in homes and offices, etc. However, I have never felt even a twinge—except for three occasion in my teens and twenties when I saw television features of the phenomenon and spent the next few days with an odd prickling feeling. In fact, I have to add a fourth occurrence: The act of writing this paragraph set off the same prickling feeling...

Similarly, a common statement in several features and articles I have encountered has been that as soon as the first employee started to complain about hypersensitivity, several others suddenly developed the same symptoms. Does this mean that there is no physical (in either sense) explanation? No; however, it does mean that sufferers lack common sense: If they were to think critically, they would realize that the probability of a psychosomatic explanation was high. Alas, instead the typical reaction to that suggestion was anger.

Even today, when (to the best of my knowledge) there is still no scientific proof of a non-psychosomatic explanation, sufferers seem to consider it insulting when they are confronted with the psychosomatic possibility. Why? Science does not deny that the problem is real, it just suggest another type of underlying reason—and one that puts the patient in a noticeably better position, where a life-long abstination from using electrical appliances and electronics (which could happen in a worst case scenario) is not needed.