The family and childhood psychosomatic disorders

Abstract

A major recent advance in the understanding of the maintenance of psychosomatic disorders has been the development of a theoretical model utilizing the concepts of General Systems Theory. The model directly addresses the impact of contextual factors upon an individual's physiologic and emotional functioning. Familial and extrafamilial influences appear to be related to psychosomatic symptoms in a circular feedback fashion. Research carried out at the Philadelphia Child Guidance Clinic has identified characteristic dysfunctional patterns of family interaction in families with a psychosomatic member. These include enmeshment, overprotectiveness, rigidity, lack of effective conflict resolution, and involvement of the affected child in marital conflict. Structural Family Therapy, systemically based family treatment incorporating goal directed interventions in family interaction, has been applied to the treatment of psychosomatic disorders in children, adolescents, and young adults with highly successful results. Therapeutic techniques are specifically designed and implemented to transform dysfunctional patterns of family interaction and provide family members with methods of effectively responding to psychosomatic symptoms while encouraging developmentally appropriate function for family members and improved overall family function. Of major importance in this work is the establishment of a collaborative medical-psychiatric team providing integrated and consistent treatment.