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When Your Doctor Thinks It's All In Your Head: What to Do


by Kevin S. Liu, M.D.

Q. I’m having a hard time communicating with my doctor. He seems to dismiss my symptoms and complaints, passing them off as psychosomatic—all in my head. How can I make him understand me?

A. I think the first thing you should do is tell your doctor how you feel. Unfortunately, when they can't determine a medical cause for symptoms, many doctors invalidate their patients’ complaints by telling them it’s all in their head. If you’re having symptoms in other parts of your body, this statement is obviously not true. You're having true physical symptoms that need to be addressed.

However, at the same time, it is possible that the origin of the symptoms is “in your head.” Mental and emotional problems can often manifest in all sorts of physical symptoms. That's probably what your doctor is trying to say. Even if that is the case, those symptoms still need to be addressed appropriately.

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Further, some chronic-pain conditions are sometimes difficult to diagnose and, to complicate matters, are often associated with psychological conditions such as depression and anxiety. It can be difficult to tell which causes the other. Chronic pain frequently causes depression and anxiety, and depression and anxiety often intensify the experience of pain.

newsletter-graphicIf your doctor doesn't listen to your complaints even after you tell him how you feel, it may be best to seek out another physician who is more attentive to your symptoms.

is a board-certified family doctor in Keller, Texas.

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Last updated and/or approved: March 2012.
Original article appeared in a previous issue of the former print magazine. Bio current as of that issue. This general health-care information is not meant as individual advice. Please see our disclaimer.

Comments (1)add comment
"All in your head."
written by JR , May 30, 2012

The breast pain was, "all in your head," until a biopsy.

Do tell -- exactly what is the script one needs to deliver in order to be taken seriously when all versions have been attempted, including saying, "I am very anxious about this," from the get-go, or being stalwart and not speaking.

Of course somatization is a very real phenomenon, and why shouldn't it be? How much longer is the medical establishment going to insist that people are all calm, stress-free creatures whose bodies would never, ever, evidence a symptom unless they were, in fact, ill with a popular disease, or, and that's a big OR - crazy. When will this lack of integration and acceptance of mind and body, stop, eh?

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