Tufts Blogs

In a year when much of what we learn is taught online, it is hard to fully engage with classes. So many of us on campus are complaining about “Zoom fatigue,” the struggle to pay attention to online classes and lectures day after day, but what many of us aren’t sharing are the positive experiences we have had in our courses this semester. I truly believe that most professors are trying to do their absolute best to establish connections with students they may never meet in person. This week, I would like to highlight Professor VanElzakker, my Abnormal Psychology professor, who I think is doing a stellar job. 

Of my five classes this semester, Abnormal Psych is the only class that I have that is asynchronous, meaning that we watch lectures on our own time and then complete assignments and exams for the assigned dates. Going into this semester, I assumed that with such little interaction with my professor and peers, this would be a horrible learning style for me; however, I have been pleasantly surprised, thanks to Professor VanElzakker’s fascinating lectures.

This week in our textbook, featured above, we covered Chapter 6: Somatic Symptom and Related Disorders and Dissociative Disorders. According to the textbook, someone who has somatic symptom disorder or a related disorder is often preoccupied by some physical symptom that is medically unexplained, leading to the patient being diagnosed with a psychological disorder. People with these disorders tend to continue to look for answers for their undiagnosed physical problem, and because of this focus on their symptoms, they are actually labelled mentally ill. When I read this, I was a bit disgruntled due to my own life experiences.

My junior year of high school, I started getting hives, and eventually, I was diagnosed with chronic idiopathic urticaria. What does that mean? Officially, it just means that I have chronic hives that can’t be medically explained; they don’t know what causes them. I’ve always felt that it means that the medical science, as of now, isn’t advanced enough to fully understand the etiology of hives, but of course, a doctor would never admit that.

So when I read about clinicians diagnosing patients with psychological disorders, because after examination, they couldn’t find the underlying cause for the physical problems presented, red flags went up in my head. While the book seems to embrace this diagnostic practice, Professor VanElzakker does not. He believes that many physical problems go undiagnosed because of the lack of decent testing, not because they stem from psychological roots. He backs this assertion by explaining that somatic symptom disorder, originally called Briquet’s Syndrome, was coined in 1859; however, the germ theory of disease wasn’t embraced until the 1880s. This means that doctors were labelling patients with a psychological disease because they couldn’t find anything wrong through tests, a full two decades before the idea of germs was widely accepted!

For those of you who are doubting how bad our testing still is, think of Covid-19 tests. First, many patients with Covid can be contagious for days before testing positive. Second, some patients who contract Covid stop testing positive after a few days even when they still have Covid. Professor VanElzakker describes one pregnant Covid patient who tested negative through her blood test, but then tested positive when they tested her placenta. Even in our age of fairly advanced medical technology, tests are not completely reliable. Because of this, is it fair to diagnose a patient who has, say, chronic UTIs with no identifiable root cause, with a somatic symptom disorder, just because our tests aren’t good enough to tell what is causing the problem? If you had a problem that couldn’t be diagnosed, wouldn’t you be preoccupied with it? Keep in mind that many of these people aren’t imagining their problems; many women do indeed get chronic UTIs, or in my case, chronic hives, for no testable reason.

Professor VanElzakker’s view of these somatic disorders gives me hope—maybe one day there will be testable ways to diagnose these patients, instead of sticking people with a label that minimizes their real physical problems. Professor VanElzakker urges us to run what we read and hear “through a lens of skepticism.” Is the prevalence of somatic symptom disorders really about 5-7%? Probably not.

Professor VanElzakker is a professor who is legitimately interested in the topic he teaches. He often goes on tangents in his lectures to expand beyond definitions and connect what he is teaching to the real world. It is professors like him who go above and beyond that make classes, even virtual asynchronous classes, intellectually stimulating. So today, my Emma’s Advice is to, as Professor VanElzakker encourages, run what you read and hear through a lens of skepticism. While that may not directly apply to your day-to-day life right now (please don’t tell your parents that I encouraged you to be skeptical about your curfew), in academia, this kind of reflection stimulates learning and new thought.