Abnormal Psychology

376 CHAPTER 8

Kirmayer, 2002; Maldonado & Spiegel, 2001). For instance, with SD, family

members may be asked not to inquire about the patient’s bodily symptoms. In

addition, support groups may help patients feel less alone and isolated (Looper &

Kirmayer, 2002).

FEEDBACK LOOPS IN TREATMENT: Somatoform Disorders

Although biofeedback and medication primarily target neurological factors, such

techniques can in turn affect the type and quality of attention paid to bodily sen-

sations, and can change the meaning made of bodily sensations (psychological

factors). CBT can provide new skills and ways of interpreting the sensations and

modifying the preoccupying thoughts, which in turn can decrease the bodily symp-

toms (neurological factor) and the attention paid to them (psychological factor).

Similarly, the relationship with a therapist (social factor) can provide reassurance

and support, and as family members change how they respond to the patient’s

symptoms (social factor), positive change can be enhanced. Figure 8.6 shows how

successful treatment of somatoform disorders affects the different types of factors

directly and through their feedback loops.

P S

N

Figure 8.6g

Treatments Targeting

Neurological Factors

Medication: Medication

for anxiety symptoms

(e.g., SSRIs)

Relaxation/biofeedback

Decreases bodily

tension

Changes neural activity

Treatments Targeting

Social Factors

Group therapy/support

group

Family therapy

Decreases isolation

Increases social support

Changes social

interactions

Changes family response

to patient’s behavior

Treatments Targeting

Psychological Factors

CBT: Breathing, muscle

relaxation, cognitive

restructuring

psychoeducation,

exposure and

exposure with

response prevention

Changes thoughts,

feelings, and behaviors

8.6 • Feedback Loops in Treating Somatization Disorder