Psychotherapy Out of Bounds

PSYCHOTHERAPY Out of Bounds, continued
Then he met Patrick and he was no longer interested in either of those issues. Patrick’s hands were absolutely deformed by arthritis. He could do almost nothing with them. The direction of his fingers was at about a forty-five degree angle with the plane of his hand. His knuckles were swollen to easily twice their normal size. He did not bother to comment on his arthritis to Felicity. After all, what could a psychologist do about that?
Now Felicity understood Patrick’s point of view and did not even try to contradict it. Heck, even the research on arthritis seemed to suggest it was not a psychosomatic disorder. In fact, Felicity knew that in one study by a psychiatrist it had been shown that the swelling experienced in arthritis occurred before, and not after, the pain. So, the study was used to conclude that the swelling caused the pain (an assumption in itself), not the other way around. And so, at best, arthritis was seen to be a somata- psychic disorder and not a psychosomatic disorder. Makes sense, right? It does not.
Nobody in his right mind would think of the pain in arthritis as causing the swelling. That is not what makes arthritis a psychosomatic disorder. The psychological causes come long before that. Although this is not necessary, the process usually starts with some kind of injury – from a fall or whatever. The injury results in a sensation of pain at or near a joint. Every time the person moves, the joint moves and the person hurts some more. Now nobody likes to experience pain. The body starts at once to do whatever it can to stop pain. If the pain comes from a joint, the body protects itself (automatically) by trying to stop the joint from moving – to reduce the pain. (Among other things, that’s what creates a limp – limping prevents quick joint movement.)

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