Recognize somatoform disorders with the BICOM BodyCheck and treat them successfully

Norbert Lindner, alternative practitioner

Dear colleagues, in today’s speech, I would like to demonstrate to you how you can di¬agnose and treat somatoform disorders.

First, let’s take a look at what the official description from the WHO reveals to us:

Somatoform disorders are physical complaints that are not, or not sufficiently, at¬tributable to an organic illness or are characterised by an intense fixation on physical (somatic) symptoms that lead to considerable suffering and/or impair daily life.

Throughout life, it is normal to experience physical discomfort from time to time: 80 per cent of the population report temporary physical discomfort without a clear or-ganic cause. Most of the time, the discomfort resolves itself and is barely noticed by most people.

On the downside, it is also not rare for someone with symptoms to see a therapist and not manage to determine an organic cause – studies have shown that this is the case for approx. 20 per cent of patients.

There are also, however, people that constantly suffer various physical discomforts without ever finding a physical cause. In many cases, the discomfort chronic and can significantly impair their quality of life.

This is called a somatoform disorder – that means that the symptoms very likely have psychological causes.

Another problem with somatoform disorders is that the symptoms cannot be effec¬tively treated with medical approaches. Therefore, the subject often waits a very long time before they actually receive effective help.

On one hand, unnecessary diagnostic procedures and treatments are often carried out that can then contribute to the perpetuation of symptoms. On the other hand, pa-tients are often not taken seriously by the therapist and are classed as “difficult to treat”. The patient is convinced that they have a physical illness and it is difficult to convey the mental causes for their symptoms to them.

Should the therapist assure them that they are completely healthy, this then triggers all the more worry for the patient because they are convinced that their physical symptoms must have a physical cause. Even the explanation that psychological factors such as fear or stress could be behind the physical symptoms is often not accepted by such patients. Many patients feel that medical treatment cannot help them, they can feel disappointed and, therefore, they always end up switching from one therapist to another.

Typical symptoms of a somatoform disorder

The symptoms of a somatoform disorder can be very diverse. The most common symptoms are those that also arise in the case of a strong arousal of the vegetative nervous system.

Typical symptoms are:

In the cardiovascular system: Feeling of pressure or stitches in the heart area,
tightness in the chest, palpitations

In the respiration system: Tightness in the chest, difficulties when breathing,
breathlessness

In the gastrointestinal tract: Nausea, stomach pains, bloatedness, flatulence, di-
arrhoea

In the gynaecological area Chronic pain in the lower abdomen, uncomfortable
sensations in or around the genital area

In the bladder and kidney area: Frequent or painful urination, difficulties in urinat-
ing, pains in the lower abdomen

On the skin: Complaints about changes of skin colour, numb-
ness, itchiness or prickling in certain areas of the skin

Relating to the brain and nervous system: Dizziness, spots in the eyes, temporary
numbness or blindness

Pain symptoms: Persistent or perennial pains, for example head-
aches, back pains, stomach pains or joint pains

Frequency of somatoform disorders

There is deviating information regarding the frequency.

According to recent studies, around 20 per cent of the population are affected by the ailment. It is assumed that around
60 per cent of those affected are women and
40 per cent are men.

A somatoform disorder mostly starts before the patient’s 25th birthday, so the first symptoms often appear in youth. In some cases, the disorder only starts at a later age. Usually, the illness exists for a long time, during which the discomfort can be much worse in some phases and better in others.

In addition, other psychological disorders are often found in patients with somatoform disorders, especially depressive disorders and anxiety disorders.

Types of somatoform disorders

According to ICD-10, there are many subtypes of somatoform disorder. The most important are:

Somatization disorder

In order to be able to diagnose “somatization disorder”, the following criteria must be fulfilled:
• Various physical symptoms without sufficient somatic explanation that have ex¬isted for longer than 2 years
• Impairment of social and family structures due to the symptoms or behaviours

Hypochondriac disorder

A hypochondriac disorder is:
• If someone is occupied with the thought of being ill with one or several pro-gressive physical illnesses for at least six months.
• If the subject also sticks to this conviction, even if medical findings prove other¬wise.

Somatoform autonomic disorder

Here, the subject reports symptoms that clearly indicate a physical illness of a certain organ system or the vegetative nervous system. e. g. symptoms in the cardiovascular system, the upper or lower digestive tract, the respiratory system or the urinary and sexual organs.

Two types of symptoms can be observed:
• Symptoms that are based on an actual reaction of the vegetative nervous sys¬tem — such as palpitations, sweating, flushes or tremors.
• Unspecific, changing symptoms — for example, short-term pains or difficulties —or tightness that can be attributed by the subject to a certain organ or organ system.

Explanatory approaches for the development of somatoform disorders

As with other psychological disorders, it is assumed that the condition has developed due to the interaction of biological, psychological and social factors.

Genetic factors may encourage the development of the disorder – for example, a ge-netically determined, particularly strong responsive vegetative nervous system.

Presumably, psychological and social factors contribute the most to the development and perpetuation of the condition So, distinct or long-term stress can lead to constant tension and to the misregulation of the internal organs.

The diagnosis of somatoform disorders

In Germany, the Screening for Somatoform Disorders (SOMS) is the most prevalent questionnaire (along with the general symptom checklist SCL-90) used to support diag¬nosis. Another resource is the freely available Health Questionnaire for Patients (PHQ-D).

(Please note that psychological disorders should also be treated by a respectively quali¬fied therapist).

Diagnosis with the BICOM Body Check

It is important for the purposes of diagnosis that an organic cause can be excluded first of all.

The easiest way to see the somatoform disorder is when it shows up in the affected field of comp aint as a diagnosis.

Diagnosis with the BICOM Body Check

What about if no diagnosis is identified and the patient seems completely healthy?
With these types of symptoms, we have seen that the symptoms that emerge the most often are those that are based on a strong arousal of the vegetative nervous system.
So, by looking at the vegetative nervous system, we can draw conclusions and diag¬nose a somatoform disorder.

The vegetative nervous system

The vegetative nervous system, also known as the vegetativum, visceral nervous sys¬tem or the autonomous nervous system.

According to the classical anatomical breakdown, it forms the peripheral nervous system (PNS) of the human body together with the somatic nervous system.

This is divided into three components:
The sympathetic nervous system (sympathicus)
The parasympathetic nervous system (parasympathicus)
The enteric nervous system the nervous system of the gastrointestinal tract

In comparison with the sympathicus and parasympathicus, it is not sub-
ject to as much regulation by the central nervous system.

The enteric nervous system is by some authors.

The boundary between the autonomous and tinct, as parts of the somatic nervous system brain, e. g. motor reflexes. In addition to this, trol centres, e.g. the respiratory centre in the is not only a part of the PNS.

The sympathetic nervous system:

It increases:

• Heart activity
• Blood pressure
• Circulation and the tones of the heart and skeletal muscles
• Metabolism

It inhibits:
• Intestinal activity

It also has an influence on:
• Lung function
• Bladder function
• Sexual organs
• Inner eye muscles
• Glandular function

The parasympathetic nervous system:
It increases:
• Gastrointestinal tract activity
• Liver function
• Salivary glands
• Urinary bladder

It inhibits:
• Heart activity
• Blood pressure
• Circulation and the tones of the heart and skeletal muscles

The sympathetic and parasympathetic nervous systems have antagonistic effects on their effector organs. Simply put, the sympathetic nervous system is responsible for the quick reaction to environmental stimuli and the mobilisation of the body (“fight or flight”) and the parasympathetic nervous system is responsible for the moderation of outwardly oriented activity (“rest and digest”). The term “antagonism” only partially applies. For many functional processes in the body, e. g. sexual function, the simulta¬neous interplay of both systems is necessary.

The enteric nervous system:
The enteric nervous system consists of a complex network of nerve cells that traverses almost the entire gastrointestinal tract. In humans, it has four to five times more nerve cells than the spinal cord. More than the brain and the spinal cord together.
This autonomous nervous system is found as a thin layer between the muscles of the digestive system. Its task is to e.g. control digestion. It can work completely autono-mously, but is subject to the influences of the sympathicus and parasympathicus

Functions of the vegetative nervous system

To maintain internal balance, essential functions, or the “vital functions” are con¬trolled by the vegetative nervous system.

This includes the heart beat, respiration, blood pressure, digestion and the metabolism. Other organs or organ systems are also influenced by the vegetative nervous sys¬tem, for example the sexual organs, the endocrine and exocrine organs like the sweat glands, the vascular system (blood pressure) or the inner eye muscles (pupil reaction).

The vegetative nervous system in theBICOM Body Check

If, in the anamnesis, we do not find any organic causes for the patient’s symptoms, there are 4 sectional views of the vegetative nervous system available in the BICOM Body Check.
With the following images, I would like to illustrate to you how the vegetative nervous system appears using the entropy points and what conclusions we can draw from it.

Parasympathicus Entropy 2 — Sympathicus Entropy 2

Parasympathicus Entropy 2 — Sympathicus Entropy 2
This image shows a well-balanced vegetative nervous system

Parasympathicus Entropy 1— Sympathicus Entropy 2

Parasympathicus Entropy 1— Sympathicus Entropy 2
Parasympathicus blockage
• The patient cannot relax due to the blockage
• or they are stuck in relaxation and cannot kick into gear

Parasympathicus Entropy 1— Sympathicus Entropy 5

Parasympathicus Entropy 1— Sympathicus Entropy 5
Parasympathicus blockage with a large amount of sympathicus activity

  • constant thoughts or unrest in the body
  • Heart agitation — High blood pressure
  • a large amount of stress stress in the activity area
  • shutting off is not possible due to the blockage

Parasympathicus Entropy 4 — Sympathicus Entropy 2

Parasympathicus Entropy 4 — Sympathicus Entropy 2
Increased parasympathicus activity
• increased digestive and intestinal activity
• irritable bowel syndrome

Parasympathicus Entropy 2 — Sympathicus Entropy 1

Parasympathicus Entropy 2 — Sympathicus Entropy 1
Sympathicus blocked
• Asthenia and lack of drive
• Normal digestive function

Parasympathicus Entropy 4 — Sympathicus Entropy 4

Parasympathicus Entropy 4 — Sympathicus Entropy 4
Increased parasympathicus and sympathicus activity

  • complete tension in the body
  • Digestive complaints
  • Constant stress

Parasympathicus Entropy 4 — Sympathicus Entropy 5

Parasympathicus Entropy 4 — Sympathicus Entropy 5
Increased parasympathicus activity and enormous load on the sympathicus
• a large amount tension in the body
• Sympathicus overload
• Digestive complaints

Parasympathicus Entropy 1— Sympathicus Entropy 1

Parasympathicus Entropy 1— Sympathicus Entropy 1
Parasympathicus and sympathicus blocked
• Burn out

Treating the vegetative nervous system

How can we have an influence on the vegetative system?
In the BICOM, we have stored four programmes and 2 programme chains for the treat¬ment and balancing of the vegetative nervous system
960 Vegetative malfunction
3465 Neurological and neurovegetative symptoms
3463 Psychosomatic disorders (1st Progr.)
3464 Psychosomatic disorders (2nd Progr.)
10170 Vegetative malfunction
10169 Vegetative dystonia
Let’s take a closer look at the chain programmes. 10170 includes the programmes:
• 3021 Improving blood values
• 960 veg. malfunction.
10169 includes the programmes:
• 915 Removing energetic blockages
• 940 CNS disorder
• 960 veg. malfunction
• 900 Activating vitality

You see that, in the “vegetative dystonia” chain, there is also a blockage programme and a programme for activating vitality.
I recommend choosing the field “Removing blockages” on the BICOM and testing out all the programmes there on patients. You will be surprised how many programmes test for blockages.

In my practice, I mainly use the programmes:

3433 Removing nerve blockages
3017 Removing deep-set blockages (also good for patients with reactions
blocked)
127 Overtreatment – Harmonising
900 Removing scar tissue
910 Removing scar tissue
125 Activating the right side of the brain
432 Shock treatment
3093 Shock treatment
911 Nerve damping
580 Lack of energy
630 Injuries of any kind
700 Geopathic balance
701 Exposure
530 Jaw joint correction

If patients mention symptoms that indicate a vegetative disorder, I like to use the chain 10169 described here as a basic programme. Especially if the patients are un¬clear on the cause of the symptoms.

I would like to reveal a small trick to you now. Even with patients with organic causes, in the first sessions I always also treat the vegetative nervous system. You will be sur¬prised at how quickly the symptoms improve in general. Then, not the chain, but the programme
3465 Neurological and neurovegetative symptoms
3084 Regulation, gen. (physical stress reduction)
960 Vegetative malfunction

In addition, when treating a somatoform disorder, we should not forget the subcon¬scious. A positive affirmation can make a big difference.
This could, e. g. be:
• I love and accept myself as I am
• I am completely healthy
• I am doing the best I possibly can
• I can handle anything
• I am worthy of being loved
• I am in flow with the rhythm of my life
• I will always do the right thing at the right time in the right place
• I am great
• I am happy

I am convinced that the treatment of the vegetative nervous system is an important element in the successful treatment of our patients and I would like to thank you for your attention.

List of references

German Society for Psychosomatic Medicine and Medical Psychotherapy e. V. (DGPM)
WHO (2010). International Classification of Psychological Disorders. ICD-10, Chapter V (F). Klinisch-diagnostische Leitlinien. 7., revised edition. ed. H. Dilling, W. Mombour & M. H. Schmidt. Hans Huber Publishing House, Bern.
W. Rief (2009). Somatisierungsstorungen. In: J. Margraf & S. Schneider (ed.). Lehrbuch der Verhaltenstherapie, Band II, S. 139-173. Springer-Verlag, Heidelberg.
Sauer, N. & Eich, W. (2009). Somatoforme StOrungen and Funktionsstorungen. Deut¬sches Arzteblatt (German Medical Journal), 2009 (1): 18a
Somatoforme Storungen von Dr. Christine Amrhein (Dossier von Pro Psychotherapie e. V.)