SOMATOFORM DISORDERS
information and the encouragement to go about solving a
The major characteristic of somatoform disorders are that
patients have physical symptoms for which there is no known
organic cause or physiological mechanism.
Patients express conflicts through bodily symptoms and
complain using the defense of somatization
Patients with these disorders repeatedly seek medical
diagnosis and treatment, even though they have been told
that there is no known physiological or organic evidence to
explain their symptoms and disability.
CLINICAL INTERVENTION:
A crisis is defined as “a sudden event in one’s life that disturbs
homeostasis, during which usual coping mechanism cannot be
resolve the problem” (Lagerquist, 2006, p 31).
Crisis result in a disequilibrium, panic may ensue when new
techniques are use and resolution fails to occur.
Crisis intervention requires problem-solving skills that are
often diminished by the level of anxiety accompanying
disequilibrium. Assistance with problem-solving during the
crisis period preserves self-esteem and promotes growth with
resolution. The therapist or other intervener, becomes a part
of the individual’s life situation. Because of the individual’s
emotional state, he or she is unable to problem solve, and
therefore requires guidance and support to help mobilize the
resources needed to resolve the crisis.
The goal of crisis intervention:
It is the resolution of an immediate crisis. Its focus is on the
supportive, with the restoration of an individual to his pre-
crisis level of functioning or possibly to a higher level of
functioning. The therapist’s role is direct, supportive and
that of an active participant.
TYPES OF CRISIS:
Baldwin (1978) identified six classes of emotional crisis, which
progress by degree of severity. As the measure of
psychopathology increases, the source of the stressor changes
from external to internal. The type of crisis determines the
method of intervention selected.
CLASS 1: Dispositional Crisis
These are distress resulting from a problematic situation in
which the therapist responds to the client in ways peripheral
to a therapeutic role; the intervention is not primarily directed
at the emotional level.
 In a dispositional crisis an individual typically lacks both
problem in an unusual way.
 The school psychologist who helps a pupil learn about a local
program for overweigh teenagers might be dealing with such
crisis.
 The major counseling strategy with these pupils is to provide
information, particularly information that would be difficult
for the child or adolescent to obtain on his or her own. If the
client is capable to doing most of the “research”, the
counselor merely points the way.
CLASS 2: Crisis of Anticipated Life Transitions
Normal life-cycle transitions that may be anticipated but over
which the individual may feel lack of control.
Examples:
1. Entering school
2. Moving from grade to grade
3. Moving to another school or moving from a self-
contained special education classroom to a mainstreamed
one.
4. The birth of a sibling or pregnancy in a teenager also fit
this category in as much as they are transitions from one
status (only child or adolescent) to another (sibling or
mother).
CLASS 3: Crisis resulting from Traumatic stress
These are “emotional crises precipitated by externally-
imposed stressors or situations that are unexpected and
uncontrolled, and that are emotionally overwhelming.”
Young (1998) noted six typed of traumatic hazards:
1. Severe illness or injury
2. Violent or unexpected death
3. Threatened death or injury
4. Acts of War
5. Natural disaster
6. Manmade industrial disasters
a. Sudden death of a family member or catastrophic illness
b. Hospitalization
c. Parental disablement or parental divorce
d. Physical abuse
e. Pregnancy
f. Sexual assault
g. Academic failure
Often, the client facing one or more of these events is
emotionally overwhelmed and unable to bring into play
previously learned coping strategies.
INTERVENTIONS
1. Help the client understand the impact of what has
occurred. The suddenness of occurrence, has not
prepared him or her to think through all of the impacts of
what has happened.
2. Exploration of the event and the attendant feeling will get
the client to gain needed perspective and overcome
defensive reactions.
3. Mobilize any existing coping mechanism the client may
have. If the individual has characteristic ways of dealing
with stress in other situations.
CLASS 6: Crisis reflecting psychopathology
Crisis situations in which general functioning has been
severely impaired and the individual rendered incompetent or
unable to assume personal responsibility. Examples include:
 Acutely suicidal individuals
 Drug overdose
 Reactions to hallucinogenic drugs
 Cute psychoses
 Uncontrollable anger
 Alcohol intoxication

4. Teaching new coping strategies, the new technique will

be more easily learned if it is close to the client’s initial
reaction.

CLASS 4: Crisis of Anticipated Life Transitions

(Maturational/Developmental Crises)
This results “from attempt to deal with an interpersonal
situation reflecting a struggles with a deeper (but usually
circumscribed) issue that has not been resolved adaptively in
the past and that represent an attempt to gain emotional
maturity.” (Baldwin, 1978)

Focal issues for this class of crises include dependency, value

conflicts, sexual identity, capacity for emotional intimacy,
responses to authority, and attaining reasonable self-
discipline.

Example: A special case such as crisis is the discovery in

adolescence of a homosexual orientation.

INTERVENTION:

 Facilitating the exploration of thoughts and feeling.

 Support the individual in crisis to redefine relationships
and develop adaptive interpersonal skills
 Helping them learn new prosocial strategies is effective.

CLASS 5: Crisis reflecting psychopathology

Emotional crisis in which pre-existing psychopathology has
been instrumental in precipitating the crisis or in which
psychopathology significantly impairs or complicates adaptive
resolution.

Examples of psychopathology that may precipitate crises

include:
A. Borderline personality
B. Severe Neuroses
C. Character disorders
D. Schizophrenia