Management of patients who describe chronic pain all over the body, associated with a range of symptoms as sleep disturbance, overwhelming fatigue, alteration in mood, or psychological distress that worsens the quality of life, is often complex and challenging. This syndrome has been named by terms such as “neurasthenia,” “fibrositis,” and “fibromyalgia”. At the present time, fibromyalgia is considered the most common central sensitivity syndrome, affecting over 5% of the population, being often observed in people with rheumatic conditions. While typically presenting in middle-aged women, fibromyalgia can affect both sexes at any age. The causes of fibromyalgia remain unknown. Significant research findings have focused on dysfunction of central pain processing, with defects in the ascending and descending pain pathways leading to increased pain perception. There are two methods used in the diagnosis of fibromyalgia: criteria-based diagnosis and clinical diagnosis. Although fibromyalgia defies definitively efficacious management, much evidence underlies the importance of treating the psychological factors that affect pain management process. The primary purpose of this paper is to provide a psychosomatic approach to fibromyalgia from three points of view of processing: the viewpoint of the medical profession, the position of the psychologist, and finally the way of thinking of people.
Telling stories (storytelling) is, above and beyond, a form of communication. It is a natural, universal, and well-known way of interaction among human beings. Storytelling, orally as well as in writing, is the sharing of personal narratives, a sort of story-sharing. With regard to chronic disease self-management, storytelling has been reported to be an exciting approach to patients and families. In this regard, families are considered very important in the management and treatment of eating disorders. Living with an eating disorder is an experience which deserves to be expressed in order to improve emotional support always necessary for patients' families. Bearing in mind that eating disorders can be chronic illnesses that lead to challenging and troublesome experiences for patients and their families, this chapter aims to think over the everyday interactions that typify family life in the context of eating disorders and specifically in the case of bulimia nervosa. We propose this text as a reflection based on different experiences when working with bulimic patients.
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