I think it is still pain and suffering. Regardless of the inability in detecting or defining a cause, does not invalidate the symptoms "It's all in your head" does not over rule "I feel pain". Perhaps it is the doctor who has the more serious problem.

Its still pain and suffering, but "its all in your head" basically means you are inflicting it upon yourself.

Ultimately, every pain is felt in the same way. Pain is simply a feedback warning from the Self to the Self that something is wrong. The cause, varies.

Rich

Pain is both a process and a perception. People feel pain sometimes that has no explanation. When it's a sublimation of some psychological issue, we call it somatization or psychosomatic. But there are also the so-called "functional pain syndromes", most famously fibromyalgia, in which people live in pain but there is no "objective" cause that we can identify. It may be a matter of heightened pain sensitivity, but it's real to the patient.

Our responsibility is to help the patient -- sometimes that means doing lots of diagnostic tests and giving pain medications, but sometimes it means NOT giving pain medications if they're not helping and they're only making things worse. There is a growing evidence basis for antidepressants, cognitive-behavioral therapy, and GABA-modifying pain medications (like pregabalin and gabapentin).

All that aside, these are incredibly frustrating diseases for patients. They don't need to be patronized by doctors, but we also don't need to practice a la carte medicine -- patients often want tests and therapies that are not a good idea for them.

This is a very important, and very difficult question.

A good friend of mine, a retired doctor, told me that in her entire life of doctoring, 80% of her patients actually needed a psychologist.

Most people that see psychologists, just need some TLC.

However, many medical doctors (and many psychologists) just do not have the sensitivity to decide when the pain is fabricated, or to what extent it is fabricated. Thats not a criticism, as I said, this is a very difficult question.

I have realised, that many aches of my own result indirectly from anxiety. When one feels anxious, one feels nauseous, and one often does not eat, or one eats food, like suger, which gives a high, and causes small aches. The situation feeds back on itself, the small aches lead to more anxiety on so on. Eventually the immune system is weakened (lack of proper nutrition) and something gives in, and this results in a medical ailment which can be diagnosed by the medical doctor.

The patient may be at the stage where they realise that something is wrong, and also remember that the last time they felt like this, they ended up getting sick.

So at what point does the psychosomatic symptom become a medical symptom?

As one can see there is a very fuzzy line between the two, very roughly speaking, as the immune system weakens. After this, the many many microbes in the local environment, or internal weaknesses can result in almost any ailment. Often a recurring problem, just happens to be the weakest organ in the body.

But the best ways to break the cycle, are : TLC prevents anxiety, remember to eat healthy food when feeling down, and an appetite stimulant can stimulate the person to eat when nausea is extreme.

But stopping yourself from feeling down, even when sick, is a psychological decision.
Many people become addicted to doctors and carers, instead of finding an internal motivation to lift their spirits.

Doctors must also be careful, that just because they cannot see the problem, they cannot conclude that it has to be psychosomatic. Even if they are probably correct 8 out of 10 times.

Patients must realise that anxiety feeds back into depression which can cause a loss of appetite which can lead to genuine physical illness.

Indeed, much of your health depends from your humor. If I am happy and tired, I continue doing things as if I wasnt. Being tired only affects me if I am unhappy at the moment

Pain, as I view it, is the mechanism that the Mind provides to itself (feedback), that something is wrong. Consider, if there was no pain. Then, what ever is causing the pain (e.g. bacteria, viruses, etc.), would continue to grow, and grow until it destroys the ability for the body and mind to survive. Pain is very valuable, and should be seen as a signal that something needs to be changed. Maybe diet. Maybe lifestyle. Maybe the activities one is performing. When I feel pain, I know something is amiss. I do not fret, but I do observe what I am doing, so that I might understand what needs to be changed.

Rich

That is true, however the body alone cannot distinguish something dangerous from something not dangerous, it only avaliates the amount of damage caused, the pain caused by a needle getting stuck on my skin would be the same if that needle contained poison (unless the poison caused imediate pain, that is). Similarly, getting tired is no big deal if I can sit down and rest at any moment, but it would be a big deal if I was in the jungle or in a war

Yes. I agree. And learning about your body and what might be causing the pain is one of the things I do in my life. Of course, in ancient cultures, there were specialists. Chinese medicine became very adept at understanding the cause of pain, by observing and touching the person. Lots of these skills are no longer being practiced. I, however, enjoy learning these skills, and have been able to take care of my family very well because of this.

For one thing, we are able to preempt the problem, by understanding the cause very early in the cycle. None of us have been to a physician in the last 27 years, and none of us take any drugs. We are all very healthy, and when we do have some illness are usually able to take care of the problem very quickly. It is a skill that I have developed, but it does take time and one has to enjoy doing it.

Rich