We need to talk about them more, we need to figure out a way to talk about illness caused or amplified by psychological aspects - especially if that illness has a physical pathological manifestation!
If you’ve been in health care long enough you’ll find that every once in a while there’s a new illness/disorder crashing down on you. And you find that your patients tend to be similar, they tend to show similar personalities.
I find them to be often exhausting my compassion, their personalities grating.
“But,” you may say, “what about ‘cause and effect’? What if so many of them are like that because of their illness?”
Possible. I’m not saying my personal impressions aren’t disputable, but I’m trying to talk about more here:
We often reject the idea that something we can put a finger on (a cellular difference in a slide) may be cause by something we can’t put a finger on, like psychology - or the abstract notion of in/sanity or a soul.
Mind you, we can easily draw psychological conclusions and generalisations where psychology alone is concerned - barely anyone will argue that anorexia is a symptom complex of parts OCD (intricate, self imposed rules that have to be followed), narcissism (low self-esteem, seeking external validation) and various personal and societal influences.
We’re even beginning to figure out “well, if a child never learned that they have a belly ache because they are upset they will begin to express any stress as a belly ache.”
But god forbid we can find something on a slide, a scan or else.
Society largely still doesn’t want to explore psychological implications of disease. It’s easier to say ‘mind over matter’ than to admit that your mind and your body are one and the same. Your damn self isn’t a transcendental spark, it’s a pretty awesome manifestation of the collective of your cells.
We can accept that love (a chemical reaction based in our brain) can give us a heartache or even broken-heart syndrome, we can accept that stress gives us a belly ache and ulcers. We can accept that these emotional responses can give us palpable, CAT-scannable, blood-count-able or operable illnesses.
So, why can’t we accept that a dichotomy in our mind, may create other diseases as well? That our brain, our hormones, our cells don’t see a difference between love, stress and possibly pathological character traits?
Crohn’s and endomitriosis are two things illnesses that have struck me with a very distinct likeness between a lot of patients.
Again, many will cry out “But they’re stressful diseases! They may take a psychological toll on patients!”. Yes - and no. I’m no psychotherapist, but I see myself as a semi-sane, observant person: a 18 year-old receiving a new diagnosis of Crohn’s does not differ much from a 35 year-old in their basic character.
And yet, the diagnosis brands them as ‘genuinely ill’, a ‘you can go to hospital when your symptoms worsen and nobody will ask why’.
It’s easy, for society, for the health care system, for patients and doctors alike.
Nobody wants to be told: “I think you have a psychological problem that contributes to your illness, getting professional help might be better at putting you in remission and getting you off your meds than our actual meds.”
Very few doctors would want to say that.
Patients are trained to want a pill/shot/operation.
Cheaper than counselling for those patients (who, in all likelyhood, would still have physical problems, I’m not saying talking will make your Crohn’s go away completely!), cheaper than accommodating for patients who may have to change their lifestyle (because of stress, etc), it’s easier than overhauling societal constructs that may make people sick.
And I’m afraid I’ll be pretty alone with my theories/opinions/feelings about psychosomatic, palpable diseases because as hard as some fight, the stigma of psychological illness, the imperative of ‘sanity’ and ‘but I get to take a pill for my actually physical problem!’ might as well be made from tungsten.
