List 3.

Principles of a biopsychosocial approach to unexplained somatic symptoms and functional disorders (54).

1. All significant illnesses affect patients on multiple levels (cellular, organismic, interpersonal, societal). 2. Somatic symptoms correlate poorly with pathological findings. 3. The emotions are embodied. 4. Somatic expression of psychological distress is a normal and universal phenomenon. 5. Language of medical discourse shapes patients' experience of illness as well as physicians' understanding of patient. 6. Stigmatization and blame further reinforce symptoms and conflict. 7. Many somatically distressed patients are chronically ill, requiring secondary prevention and functional assessment. 8. Treatment should be oriented toward care as well as cure and cause.