Psychosomatics 40:34-43, February 1999
© 1999 The Academy of Psychosomatic Medine
Attachment and Interpersonal Communication in Somatization
Scott Stuart, M.D., and
Russell Noyes, Jr., M.D.
Received August 3, 1998; accepted August 20, 1998. From the Department of Psychiatry, University of Iowa, Iowa City. Address correspondence and reprint requests to Dr. Stuart, University of Iowa, Department of Psychiatry, 200 Hawkins Drive, Iowa City, IA 52242. E-mail: scott-stuart{at}uiowa.edu
The authors review the research on childhood antecedents and personality contributions to the somatoform disorders, as well as research on social influences during adulthood. Based on these data, the authors hypothesize that somatizing patients display anxious attachment behavior that derives from childhood experiences with caregivers. Early exposure to illness increases the likelihood that distress will be manifested somatically. When under stress as adults, somatizers use physical complaints to elicit care. Somatizers' interpersonal interactions with others, including physicians, ultimately lead to rejection that reinforces the somatizer's belief that he or she will be abandoned. Modification of physicians' responses to these patients may improve treatment outcomes.
Key Words: Attachment • Communication • Somatization
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