ABSTRACT
Four perspectives can provide a comprehensive yet flexible approach to the evaluation of a patient in distress with a psychogenic disorder. Each individual patient will have a different combination of the four perspectives that formulate the patient's problems. The perspectives identify the patient with a psychogenic disorder as a patient who is a composite of personal vulnerabilities and strengths but afflicted with diseases, struggling through life events, and motivated to behave for various reasons. Each individual perspective has its own logical process for evaluation and subsequently directed treatment. Although the perspectives are complementary, they each remain distinct and essential to the formulation of a patient's disability. This comprehensive and integrated formulation of a patient supports an approach to complex psychogenic cases that defy a simple list of diagnoses and nonspecific treatments. The patient does not have to fit into one theoretical approach to receive an available treatment. The treatments prescribed are now designed from the individual formulation and relevant perspectives.
KEYWORDS
Psychogenic - disease - behavior - meaning - personality traits - treatment
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Michael R ClarkM.D. M.P.H.
Associate Professor and Director, Chronic Pain Treatment Programs, Division of General Hospital Psychiatry, Department of Psychiatry and Behavioral Sciences
The Johns Hopkins University School of Medicine, Osler 320, 600 North Wolfe Street, Baltimore, MD 21287-5371