PSYCHOTHERAPEUTIC APPROACHES TO PATIENTS SUFFERING FROM SOMATOFORM PAIN

This article focuses on somatoform pain disorders in elderly patients. Defined as a variant of the somatoform disorders, somatoform pain rep resents a disorder characterized by significant, physically experience d pain that is not (fully) explained by a medical condition. Although epidemiological data are sparse, the prevalence of somatoform pain dis orders appears to decline with aging. Psychological factors are assume d to have an important role in the onset, severity, and maintenance of somatoform pain. In this article, two case reports are presented in o rder to illustrate the phenomenon that earlier pain experiences, e.g., in the context of a physical disorder or in the context of traumatic events, may ''pave the way'' for somatoform pain syndromes. Later acut e mental stress or psychological conflicts may then precipitate the on set of somatoform pain. With respect to therapy, one should consider t hat patients with somatoform pain experience and interprete their suff ering as a physical disorder. When applying psychotherapy to patients with somatoform pain disorders the therapist has to recognize and to a ppreciate eventual previous pain experiences which may have ''paved th e way'' for the present disorder. Only after having established a ther apeutic relationship can one try to interest the patient in the indivi dual emotional and cognitive aspects that may underly the disorder. In addition to depressive feelings and feelings of guilt, grief about th e loss of bodily functions may be of special significance for the onse t and maintenance of somatoform pain disorders in elderly persons.