An exploration of the role of psychotherapy for fibromyalgia syndrome, in the context of underlying trauma and insecure attachment

Abstract

Fibromyalgia Syndrome (FMS) is the most common cause of chronic, widespread pain in Europe and North America (Ungureanu, 2011). FMS is becoming more widely recognised in the medical community; however, the diagnosis remains vague and non-specific. The organic causes of this condition remain unclear. There appears to be a complex interplay between the different psychological and physical features of FMS but there is evidence of a high prevalence of psychiatric comorbidities in FMS, including post-traumatic stress disorder (PTSD) (Ehlert, 2001). Trauma and dissociation tend to be interrelated, and many pathological FMS features resemble PTSD (Peres et al, 2009). Individuals with PTSD symptoms often present with concurrent pain, and vice versa (Roy-Byrne et al., 2004). Over the past decade, PTSD treatment has become more sophisticated, resulting in improvement in symptomatology and patient quality of life (Peres, 2009). This study aims to explore the commonality between trauma and FMS and the common pathology of each, in order to identify overlapping therapeutic options which may be beneficial for FMS sufferers. An insecure attachment model may contribute to the dysfunctional regulation of stress and emotion and may be a risk factor for the development of chronic pain syndromes like FMS (Kowal et al., 2015; Griffin & Bartholomew, 2005). The mechanisms by which these maladaptive processes are interconnected are not well understood. This paper attempts to draw these links and proffer some clarity on these associations. The co-occurrence of trauma and FMS, and the overlap between trauma and insecure attachment, is the focus of this study (Cohen et al, 2002; Pall,2001) The article presents an overview of these overlapping relationships with the aim to increase the understanding of this complex disorder. The final part of this dissertation considers the role of psychotherapy as a viable treatment option for FMS. The connections drawn between FMS and trauma, as well as insecure attachment, may help us to conceptualise the painful core of FMS and approach a therapeutic technique which will provide greater relief from the burden of illness. Ultimately, we must treat this complex condition by respecting that no simplistic approach exists to its management and treatment.