[Cognitive therapy of subjective somatic symptoms]

In this article we present a model for the interaction between physical, psychological and social factors in the production of subjective somatic complaints, which is the most common reason for visiting a doctor. Especially if the patient has subjective somatic symptoms for which there is no apparent organic reason it may be important to motivate the patient to examine all the different factors that contribute to the vicious circle he/she often enters into. The following elements of this circle are explained: Physical (symptoms, signs, findings), beliefs (thoughts, cognitive processes and cognitive schemas), feelings (emotions), behaviour (all we say and do) and the so-called X-factor, which represents everything we do not know. The model might help us in our relationship to the patients, and can be used both in connection with known somatic disease and with conditions with a multifactorial genesis, like somatoform disorders.