A common cause of psychophysiologic disorders that is not often discussed is a lack of self-care skills. These patients care for family, friends, co-workers and neighbors but not as much for themselves. Good screening questions for this issue are:
• Do you often find yourself neglecting your own needs because you are helping others?
• Do you take care of everyone you know but have difficulty finding time for yourself?
Many of these patients grew up in environments where their attention was diverted away from play and toward problems in the home. This resulted in lack of sufficient time to learn how to self-indulge. Consequently, as adults, many of these individuals have little concept of personal time and rarely take a break from their responsibilities. Psychophysiologic illness may be the result.
Treatment begins with helping the patient recognize what they missed when young. It is helpful to ask how the patient would feel watching a child they care about growing up as they did. Next, encourage setting aside a few to several hours per week to focus on learning self-indulgence. Months of trial and error may be needed to find activity that gives guilt-free enjoyment. As this is accomplished, physical symptoms often improve steadily.