[Difficulties and pitfalls in the approach to psychosomatic diseases]

The specific particularities, difficulties and, in some instances, pitfalls which are attendant to the approach of "psychosomatic" patients may be a source of therapeutic satisfactions for the practitioner but also of feelings of uneasiness or helplessness. The existence of a psychosomatic relationship, i.e. of evidence which connects, at least in part, a somatic disorder to the psychological context in which it occurs, and the characteristics of the psychosomatic mechanism, i.e. of the various modalities through which psychological distress is converted into physical suffering (physical behaviour and attitudes, conversion hysteria, functional disorders, so-called psychosomatic diseases) are the two questions to be addressed as soon as diagnosis is considered. The difficulties and pitfalls are mostly met during management; the role of the physical practitioner is underscored; some utilizations of psychotropic agents as well as some of the physicians' attitudes and phrases are discussed; the value of methods involving the body (relaxation, etc.) is recalled.