All in your head?

Psyche and Soma

Fibro is, in the strictest sense, psychosomatic; in other words, there is a clear connection between the mind and body. Stress exacerbates symptoms; relaxation and stress reduction alleviate symptoms. However, this is not to say that the pain is not real, or, as many of my cases have been told, “all in your head.” If this were the case, heart disease, stroke and ulcers could also be deemed psychosomatic. It is abundantly clear to the suffering adolescent that stress affects her symptoms. It is in the best interest of all the practitioners involved to not only understand and acknowledge this, but to strengthen awareness of the mind-body link throughout treatment.

While practitioners have come to understand that Fibromyalgia is a real syndrome, there is a social phenomenon that perpetuates the belief that it is a “soft” diagnosis. This myth is often then reinforced by the absence of Fibro’s most common presenting symptom (pain points) in children and teens. The diverse and often varying or shifting symptoms in adolescent onset Fibro further confuse many practitioners. 

The next step is to assemble a treatment team. 

If the teen does not trust the PCP, it may be necessary to find her a doc of her own. In choosing a physician, consider the following statement; Fibromyalgia hurts. It really, really hurts. If the PCP suggests the symptoms are not real, or are in some way exaggerated, this is an indication that this doctor may not be appropriate for your treatment team. Fibro and its symptoms are largely subjective and self-reported. So, Fibro must be treated in the spirit of the great truism of mental health, “everyone’s pain hurts.”

The core of the treatment team should be a cognitive behavioral therapist.

Next: How can CBT help?