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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Catastrophizing Illness: Mind and Body Revisited

Allan N. Schwartz, LCSW, Ph.D. Updated: Jan 5th 2009

 Did anyone ever say to you that it could not have hurt that bad when you were sick because "I had that virus and it was nothing?" Well, that is the topic of this posting. Each of us experiences illness and pain differently. Whether we feel depressed and anxious affects our perception of things. This was confirmed in a recent study. 

The Study:

Dr. Afton L. Hassett from the University of Medicine and Dentistry of the Robert Wood Johnson Medical School, New Brunswick, New Jersey, and colleagues, studied a total of 159 patients seen at an academic Lyme disease referral center. Their findings appear in the December 15, 2008 issue of "Arthritis & Rheumatism." Among the things they found was that patients suffering from chronic Lyme disease tended to catastrophize their symptoms. This exaggeration of symptoms resulted from psychiatric anxiety and depressive disorders.

Specifically, these chronic Lyme disease patients displayed a greater tendency to catastrophize pain, had higher levels of negative affect, lower levels of positive affect, a greater number of symptoms and worse functioning.

In addition, Dr. Hassett found that almost 47% of the chronic Lyme disease patients qualified for a diagnosis of fibromyalgia. He stated that "Sleep disturbance is common in most patients with fibromyalgia and this appeared to be the case in many of our chronic Lyme disease subjects." Symptoms improved when the sleep disturbances were treated.

However, the researchers are unable to say whether these psychiatric symptoms predated the onset of Lyme disease or were the outcome of having a chronic illness.


It is important to understand that this research in no way suggests that Lyme disease is psychological rather than physical in nature. This disease, like all others, are very real. The aches, pain and fever associated with illness are not imagined.

It is also clear that the way each person experiences disease symptoms probably varies according to their individual physical and psychological characteristics.

In other words, I am venturing to make a personal, albeit, professional guess, that the tendency to exaggerate symptoms has a lot to do with depression, anxiety, and personality disorders that predate the onset of an illness. That is to say, this has been my observation in working with a large number of psychotherapy patients whose tendency was to somaticize their illnesses.

My experience with patients diagnosed with fibromyalgia is that, while growing up, they experienced extremely stressful lives, often including traumatizing events such as witnessing domestic violence between angry and combative parents. Or, they lived with one or both parents who were emotionally distant and rejecting.

Fibromyalgia is a chronic disease with symptoms that include body and muscle aches and pains and extreme exhaustion.

It has been my observation that in many cases of fibromyalgia, patients perpetuated their abusive histories by marrying partners who, themselves were either physically abusive or rejecting and emotionally unavailable.

In other words, each of us experiences life differently, according to our physical and emotional makeup. Form one individual to another there are great sensation and perception may vary greatly. This is part of the reason why it is important to be patient with people who sees things differently than we do. The wife may say, "gee, its hot," while the husband will state, "no its not, its cool."

Your comments are welcome and encouraged.

Allan N. Schwartz, PhD




Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

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