The biopsychosocial approach to adolescents with somatoform disorders

Somatoform disorders are presented in the first article in this issue of Adolescent Medicine Clinics because the physical symptoms that cause the adolescent to present for diagnosis and treatment reflect the interaction of the psyche and the soma in ways that are poorly understood. Because of dualistic conceptualizations that are encouraged by technology such as MRI, CT scans and other technologically advanced tools, patients who have these conditions often suffer. As noted by Cassell [35], "suffering is experienced by persons, not merely by bodies, and has its source in challenges that threaten the intactness of the person as a complex social and psychological entity." Clinicians who care for adolescents who have somatic complaints also suffer when they are unable to provide relief of an adolescent's suffering. Cassell [36] noted that "physicians are less skilled at what were once thought to be the basic skills of doctors-discovering the history of an illness though questioning and physical examination, and working toward healing the whole person." The biopsychosocial approach offers a means of working toward healing the whole person, and the focus of this article is on practical solutions to difficult challenges that are presented by adolescents and their families.