August 1975

A Conceptual Model of Psychosomatic Illness in ChildrenFamily Organization and Family Therapy

Author Affiliations

From the Philadelphia Child Guidance Clinic and the Children's Hospital of Philadelphia.

Arch Gen Psychiatry. 1975;32(8):1031-1038. doi:10.1001/archpsyc.1975.01760260095008

Linear and open systems (multiple feedback) models of psychosomatic illness in children are contrasted in terms of their implications for cause and treatment. An open systems family model is presented that describes three necessary (but not independently sufficient) conditions for the development and maintenance of severe psychosomatic problems in children: (1) a certain type of family organization that encourages somatization; (2) involvement of the child in parental conflict; and (3) physiological vulnerability. Predisposition for psychosomatic illness, symptom choice, and maintenance are discussed within this conceptual framework. We report on family therapy strategies based on this model and the results of family treatment with 48 cases of "brittle" diabetes, psychosomatic asthma, and anorexia nervosa.