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Psychosomatic Medicine: Understanding Disease in a Broader Context 07.26.2021

In recent years, psychosomatic medicine has been the topic of numerous debates in the mass media and among healthcare professionals. At MY CLINIC, we support the holistic approach embodied in psychosomatic medicine. Part of that is allowing the patient to better understand this concept and to describe the options offered by psychosomatic treatment at our family clinic.

We have discussed psychosomatic medicine with MUDr. Michaela Štěpánová, a certified psychosomatic specialist who oversees general practitioners and internal medicine specialists at MY CLINIC. An alumna of the Third Faculty of Medicine, Charles University, where she majored in general and preventative medicine, MUDr. Štěpánová is a certified internal medicine specialist. She began to investigate psychosomatic medicine shortly after graduating from medical school during her tenure at a psychiatry clinic. Later, she underwent a four-year training program in family and psychosomatic therapy, including the subsequent supervised delivery of care.

Psychosomatic Medicine

The notion that the body and the soul are intertwined was mentioned by Greek philosopher Plato already in the fourth century B.C. However, the term psychosomatic first appeared in literature only much later, specifically in 1818, courtesy of German physician Johann Heinroth. In the Czech lands, the psychosomatic approach began to be widely discussed in the 1970s. Today, psychosomatic medicine is an officially recognized branch of medicine that has been fully integrated into the framework of the Czech Medical Association of J. E. Purkyně since 2014.

Psychosomatic medicine treats conditions, symptoms, and diseases where the main cause is the patient’s mental state and social environment. In no case is psychosomatic medicine part of alternative let alone esoteric healing methods. Psychosomatic medicine is an interdisciplinary medical field exploring the relationship between psychological and behavioural factors and bodily processes.

“We all get sick in the context of our family, relationships, work, social status, and social background. All of that has an effect on the progress of diseases we contract, including symptoms,” explained MUDr. Štěpánová.

Medical Conditions Treated by Psychosomatic Medicine

In today's busy times, people are exposed to a multitude of stress factors. Although the perception of stress and the ability to cope with it differs from person to person, the physiological mechanism remains the same. Stress makes the adrenal glands produce and release cortisol, a hormone that increases blood pressure and sugar level. Cortisol also reduces the production of T-lymphocytes, which disrupts immunity and is liable to make a stressed person more prone to respiratory and infectious diseases. Likewise, it can cause insomnia and excessive weight gain. It is obvious that a person’s psychological state is narrowly tied to his or her bodily functions.

All things considered, psychosomatic medicine is growing in importance, and it is often resorted to in the treatment of what is referred to as medically unexplained symptoms, cases where the patient’s ailment cannot be diagnosed even if multiple tests and examinations are carried out. Such cases might involve functional disabilities, fibromyalgia, fatigue syndromes, irritable bowel syndromes, anorexia, and panic attacks resulting in somatoform disorders, such as palpitations, arrhythmia, shortness of breath, chest pressure, and others.

Thus, there is a wide range of conditions that can be treated using psychosomatic medicine. The prerequisite for treatment to be successful is establishing mutual trust between the patient and the physician, where both are equal and both influence one another. On the one hand, the physician unconditionally accepts the patient’s mental state. Conversely, the patient must be willing to undertake a long-term effort to change his or her personal situation. The patient must be prepared to consider his or her problems in a broader context, as opposed to from a purely biological viewpoint only.

MY CLINIC Psychosomatic Program

Psychosomatically oriented treatment incorporates cooperation between various medical specialties, including an internist, a general practitioner, a psychologist, a dermatologist, a gynaecologist, and a rehabilitation specialist. The entire process is overseen by a psychosomatic medicine specialist.

“At MY CLINIC, we allot an ample amount of time to the patient's examination, and we rely on close cooperation between individual specializations. Both play a very important role in the practice of psychosomatic medicine,” explains MUDr. Štěpánová.

Provided care is truly comprehensive. The process starts with a standard health check by an internist that is complemented with necessary laboratory tests and, where indicated, followed by specialized examinations. Subsequently, an interview is conducted with the aim of fine-tuning the patient's anamnesis. Finally, treatment is delivered in the form of psychotherapeutic sessions. As the other stages of the therapeutic process, treatment is administered in coordination with other medical specialists to ensure that the holistic approach to therapy is as effective as possible.

The psychosomatic care program offered by MY CLINIC includes a 90-minute introductory examination and seven 60-minute sessions. The recommended interval between sessions is two to four weeks. After that, follow-up treatment is arranged between the patient and the physician.

Example of Successful Treatment

The far-reaching potential of psychosomatic medicine is best illustrated on a specific case. MUDr. Štěpánová was visited by a young patient who complained of symptoms indicative of the irritable bowel syndrome, a very bothersome condition exhibited by highly irregular stool patterns.

The patient had undergone multiple specialized examinations, including gastroscopy, colonoscopy, ultrasound, and tests for the autoimmune intestinal disease. She had a rational attitude and was able to trace the possible causes of her problems, which had begun to emerge already during her adolescence. That was the first, albeit necessary, step on the long road to recovery.

“We worked on the problem together using psychotherapeutic sessions during about a year, where we paid close attention to uncovering subconscious factors liable to cause the patient’s difficulties. I’m happy to report that the long process brought the desired results in the end. The patient now has a happy family, her own child, and no longer experiences bowel movement problems,” MUDr. Štěpánová satisfactorily concluded.

The full interview in Czech language with MUDr. Michaela Štěpánová is available here:

MY CLINIC · O psychosomatickém přístupu s MUDr. Michaelou Štěpánovou - Podcast MY CLINIC

The psychosomatic program at MY CLINIC is directed by: