Somatoform Disorders and a History of Abuse

• Summary: Somatoform disorders and functional somatic syndromes are defined as the presence of physical symptoms in the absence of sufficient tissue or organ damage to account for the degree of pain or dysfunction. Many people who suffer from these disorders have a history of childhood abuse. Because these individuals may also have a number of other difficulties in living, social workers encounter such clients in diverse fields of practice. Clients who fall into the category of adult survivors of abuse with a somatoform disorder may experience certain interventions by doctors, therapists, and other helping professionals (including social workers) as repeating interactions they had with their abusers.

• Findings: Adult survivors of abuse who have a somatoform disorder often have parallel experiences in terms of their abuse and their somatic symptoms: important others communicate that the abuse and the symptoms are not real, are the client’s fault, and/or that the client is over-reacting to the abuse and symptoms. Furthermore, adult survivors of abuse may experience helping professionals as distinctly non-nurturing and as engaging in distancing behaviours. These interactions may stand in the way of helping members of this population, or even add to the client’s distress. There are specific practices in which the social worker may engage to help avoid these kinds of relations.

• Applications: Social workers in a number of fields of practice may be alerted to dynamics common among adult survivors of abuse with a somatoform disorder. In the event that a client falls into this category, the informed social worker can avoid recapitulating abuse dynamics as well as help clients understand their diagnosis and why interactions with helping professionals may have been upsetting.