It is frequent that when people hear “psychosomatic illness”, they immediately think of “psychic origin”, leaving aside the “somatic” part, although it is included in the word itself.
This misconception is understandable in any person except for health professionals, who have the responsibility of knowing and trying to use all the resources available in the medical sciences when carrying out their duties. In this sense, it seems as if many professionals had erased more than a century of knowledge that helps to broaden clinical medicine.
Fortunately, this is not always the case, and sometimes it is possible to do team work. When this happens, each specialist contributes with his own knowledge, and there is no fight for territory, something that would cause more damage to the already suffering patient.
In order to illustrate the difficulties faced by those of us who work with psychosomatic disorders, I will begin by giving some personal estimates. These estimates may seem surprising if we think of the suffering of FM patients, the anxiety they go through while waiting for new information regarding the illness, and then analyze the reactions they have to an alternative way of dealing with it.
When I first started working with FM, only 40% of the total of the people inquiring for information accepted to come to a free personal interview to be given detailed answers to all their questions.
The rate of calls according to gender was, approximately, 70% female, many of whom were worried about some other member of their family suffering from the disease. And with regards the other 30% (males), only 50% of them eventually came to an interview. And even though they all expressed their interest, no one was ready to give it a try.
From the people who started their treatment, 50% decided to quit in the short or middle term. Therefore, the conclusions that I expose in this article are based in the work done with those patients that didn’t give up and still continue with the treatment.
I mention these estimates because, even before I started working with this disease, one of my hypothesis, that was based on my almost 34 years of experience in the field of psychosomatic disorders was being confirmed: that there is. an unconscious resistance of patients to the possibility of recovery.

I will now try to describe the work I have been doing for quite a long time.
My training as a Psychoanalyst is the instrument I use when I research on fibromyalgia, try to understand it and work with patients that suffer it. I focus on the emotions, thoughts and feelings of the patients and the pain they suffer.
I try to make sure that at least the medication they take will produce the desired effects, because in the best of cases it only brings relief for just a few hours or days, and sometimes, it does not even provide complete relief.
Usually, the pharmacological treatment for fibromyalgia is based on analgesics, anti-inflammatory drugs, antidepressants ( to increase the level of tolerance of pain, both physical and psychic), anxiolytics, muscle relaxants. Some of these contain drugs, corticoid for example, that in the middle or long term produce side effects that are eventually added to the already existent illness and so are sometimes mistaken for it.
This reality supports the idea that medication can be reduced as pain decreases and disappears for longer periods.

The specific physical exercises indicated in each case play an important part, because they fight the patient’s tendency to respond with severe contractions to situations like this (phrases between inverted commas are exact quotations of the patient’s statements): “I can’t find a solution”, “It is like carrying a heavy bag on my shoulders”, “It is a load I can’t take off me”, “It’s like living with a harness all day long”, etc. Therefore, patients must take up exercise a part of their daily life.

I consider it important to communicate a THERAPEUTIC APPROACH TECHNIQUE through which positive results can be achieved in a shorter period of time.
I work with small groups of people that suffer from FM. These group sessions are usually complemented with private ones. In private meetings, the issues brought up during group work are dealt with in more depth.
Group work helps patients to listen, to view, and to understand themselves in a way they had never done before. This way they are able to leave their passive role of victims and take an active role, in the search of some relief.
There are asymptomatic periods (absence of pain) for several months. The occurrences become sporadic, in an incredibly smaller proportion, and for a very short time. This is because when focusing on the illness development, one starts to recognize what produced the onset and, therefore, which is the effective way of finding a way out.
Basically, the idea is that this process of raising awareness will modify the response to the affection. In this particular case, the occurrence of muscular pain.
The tendency to the affliction will probably continue, but it is possible to face it and deactivate its effects.
Other of my objectives is that, as the patient had a strong feeling of loneliness, they will find some immediate relief as soon as they meet some others going through their same situation: “So, I was right, it is not as they say, that I complain about nothing and I make it all up”, “They made me feel I was crazy”.
My initial proposal is to work with the illness history: when it began, which situations they were going through at that time, etc., with the aim of integrating it with the rest of their life. Pregnancy or child birth, for example, are recurrent situations for the start of the illness.
In the first group meetings, similar personality characteristics begin to show. These characteristics include: excessively demanding with themselves and with others, perfectionists, hypercritical, generous, etc.
In the short term, patients discover that, although manifestations vary from one individual to another, they all share not only the illness but also some aspects of both their childhood and adulthood history. They say: “It is as if your mother and mine were sisters”, “When I listen to you is like listening to myself”. These are some of the habitual reactions of the members of each group, despite their differences in age, activity, marital status, way of life, etc.
This made me think of the existence of vital traumatic situations common to all that act as factors that, together with a previous constitutional tendency, generated in the patients a certain predisposition. Then, some initial triggering factor, bearing a special meaning for them, triggered off the illness. A triggering factor which would have not functioned as such for other people.
Each time in their life in which they are faced with circumstances that apparently bear the same meaning for them (although in an unconscious way), they respond in the same way.
To observe and listen that others feel and react in a similar way to situations in life which are structurally similar helps patients connect more freely with their own feelings, thoughts and desires and recognize them as their own for the first time. Thus, the “resistance” to accept their existence is reduced.
This “resistance” provided me an explanation for the “surprising” estimates mentioned above: patients find it difficult to face the real problems affecting them as they view them as impossible-to-solve dilemmas, and to UNDERSTAND that, even though their suffering is caused by FM, the illness is just a RESPONSE TO A PREVIOUS SUFFERING OF A DIFFERENT KIND.
With this work, in many cases medication has been reduced until completely eliminated.
To give a general idea of what is done in group meetings, I will transcribe some phrases that I registered during the first encounters:
“I can’t get him off my mind, he is like a burden”
“I know I take charge of everything”
“I felt I was going to explode, but I controlled myself, as always”
“I need people to think I’m perfect”,
“I reacted like mad, I felt frightened of myself”,
“When I realized, I couldn’t move”
“What used to be pleasure became an obligation then, a burden”
“All they expected from me, became real”
From these phrases on, we started to work on the feelings and thoughts that couldn’t be expressed before and begin our way to pain relief and disappearance. These other statements show this:
“I sometimes feel I want to kill my daughter”,
“I know I’m too inflexible and hard with people and with myself too”
“If I don’t control myself, I will send all to hell”
“I sometimes think that I got ill so as not to divorce”
“I never thought I could have so much anger inside”
“I hadn’t noticed I was depressed”
“I had never realized that I was so competitive”
These examples are just part of the work we do. If when reading this article, people who suffer from FIBROMYALGIA recognize themselves in any of these phrases, I can say one of my primary objectives has been achieved.
Finally, I will transcribe a text that one of my patients, a writer, brought to the group as a testimony of her experience. Of course, she has given me her consent to do so.