When Stress Causes Pain

I don’t recall ever encountering a conference that included internists, psychologists, psychoanalysts, a gastroenterologist (myself) and a public relations expert all addressing the same clinical issue.  Yet this is what came together at UCLA this weekend to address physical symptoms caused by psychosocial stress.  Nearly 200 attended and it was remarkable to see the consensus that grew out of such disparate clinical experience.

At the conclusion, those of us who created the conference met with public relations experts, fund-raisers, an advertising manager and a broadcast media producer who has won six Emmys to consider strategies for getting our message to those who need to hear it.  I was able to summarize the message in nine words: stress can cause real symptoms, effective treatment is available.  Promoting this concept is a daunting task but the energy in the room reflected long-term commitment from all involved.

One measure of the mountain we will need to climb was described by one of the psychoanalysts.  A few of his colleagues have suggested he focus on his client’s physical symptoms while they work with that same client’s “other issues”, as if the two were not inextricably linked.  This revelation of ignorance of a basic concept in mind-body medicine within the mental health profession was not too surprising, unfortunately, but was sobering nonetheless.  It reminded me of a story I have told here previously about a medical clinician who failed to find the connection between her patient’s symptoms and the domestic violence the patient suffered.  When a social worker and I helped the patient get a new place to live and her illness then resolved, the clinician responded by writing “thank you, it is reassuring to know I didn’t miss anything important.”

With experience like that, it is heartening to recall the motto of the Texas Rangers:  “A little man can whup a big man every time if the little man is in the right and keeps a comin’.”

Tags: ,