Integrating the Mind-Body Split

Abstract

Somatic fixation is a process whereby a physician and/or a patient or family focuses exclusively and inappropriately on the somatic aspects of a complex problem (1). Somatic fixation can occur not only in hypochondriasis, somatization disorder, and psychosomatic disease, but in any illness, especially chronic illness, when there is a one-sided emphasis on the biomedical aspects of a multifaceted problem. In spite of very difficult life situations, somatically fixated patients tend not to present with anxiety, depression, or trouble coping, but with numerous physical symptoms. The number of patients in any family practice with some degree of somatic fixation is high. One study found that one-half of all medical patients had symptoms of undetermined cause (2). Another study found somatization disorder in a family practice to be not only a prevalent problem, but also an expensive and difficult one. deGruy et al. found that these patients had a 50% higher rate of office visits, 50% higher charges, charts that were close to twice as thick as the average chart, and significantly more diagnoses than matched controls (3).