When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

It is well known that virtually any serious organic illness or injury can produce emotional suffering, either in the form of physical pain or in the form of anxiety and depression. Chronic pain is a chronic stress and can lead to the same emotional problems as prolonged stress of any variety: anxiety or depression. Similarly, prolonged severe anxiety or depression can cause physical deterioration and make the body more susceptible to disease.

There are, then, two "vicious circles," or feedback loops, that can play a role in causing or aggravating emotional disturbance:

The two "vicious circle" or feedback loops that may
exist between physical disorders and emotional disturbances

In the first loop, an underlying physical disorder, which may be a disease or a physical injury, leads to emotional symptoms (and very likely to physical symptoms as well, although these may not be as pronounced). However, the emotional reactions that are produced can themselves make the physical disorder worse, and certainly emotional disturbance makes living with and treating the underlying physical disorder more difficult.

In the second loop, emotional disturbances cause certain physical disorders: a peptic ulcer, heart palpitations, ulcerative colitis, backache, hypertension, or high blood pressure, etc., and may predispose certain individuals to arthritis, cancer, or diseases of the immune system. Once a psychosomatic link has been established between a troubled mind and the body, and an organic disorder has come about, the physical disorder, in turn, can produce stronger or more exaggerated emotional reactions. Anxiety or depression may increase because the person is now both physically ill and emotionally troubled.

These two so-called positive feedback loops can obviously lead to a runaway process that becomes worse and worse. Psychosomatic medicine focuses on the second of these; our focus here is on the first: physical origins of emotional disturbance.

Underlying physical disorders of this kind include metabolic diseases, disorders and diseases affecting the brain and nervous system, head injuries, other physical disorders and conditions, infectious diseases, reactions to medication, and drug addiction and alcoholism. Each is discussed in the remainder of this chapter.