The Effect of Psychodrama on Fibromyalgia Syndrome: A Case Report

Abstract

Fibromyalgia Syndrome (FMS) is a chronic pain syndrome that often coexists with common musculoskeletal pain, sleep disorders, bowel syndrome, mood disorders, and fatigue. Although the aetiology of FMS pain has not been elucidated yet, psychotherapy methods are used in addition to physical methods to treat these pains. This study aims to examine the effect of psychodrama on a 62-year-old patient with back and chest pain and who lived alone. This patient participated in psychodrama group psychotherapy with 8 members who were all female and diagnosed with FMS. An informed consent form was obtained from the case for the study. This research is important because there are very few studies on fibromyalgia complaints with psychodrama group therapy, and it contributes to the literature. Studying the case with past trauma and losses in the psychodrama scene has led to a significant reduction in fibromyalgia complaints. As a result, the patient's pain level decreased from 90% to 32.5%, and the anxiety level decreased from advanced to normal. Thus, psychodrama group psychotherapy was found to be effective in reducing FMS pain.

Keywords

• Fibromyalgia syndrome
• psychodrama
• pain
• case report
• psychotherapy
• Fibromyalgia syndrome, psychodrama, pain, case report, psychotherapy

References

1. Altınay, D. (2003). Psikodrama grup psikoterapisi el kitabı. İstanbul: Sistem Yayıncılık.
2. Altınkılıç, S. Ateşçi, F.F. and Toker Uğurlu T. (2020). Fibromiyalji sendromu tanılı kadınlarda psikodrama grup terapisinin ağrı, depresyon ve yaşam doyumu üzerine etkileri. Elektronik Sosyal Bilimler Dergisi, 19(76), 2153-2164.
3. Anderberg, U., Forsgren, T., Ekselius, L., Marteinsdottir, I., & Hallman, J. (1999). Personality traits on the basis of the temperament and character inventory in female fibromyalgia syndrome patients. Nordic Journal of Psychiatry, 53, 353–359.
4. Anderberg, U., Marteinsdottir, I., Theorell, T., & Von Knorring, L. (2000). The impact of life events in female patients with fibromyalgia and in female healthy controls. European Psychiatry, 15, 295–301.
5. Bal, P.N., Şener, Ö. (2015). Psikosomatik hastalıkların iyileştirilmesinde psikodramanın etkisi. Inesjournal, 2, 310-325.
6. Bergman, S. (2005). Psychosocial aspects of chronic widespread pain and fibromyalgia. Disability and Rehabilitation, 27, 675-683.
7. Blatner, A. (2000). Foundations of psychodrama: History, theory, and practice (4th ed.). Springer.
8. Bernard, A.L., Prince, A., Edsall, P. (2000). Quality of Life Issues for Fibromyalgia Patients. Arthritis Care and Research, 13, 42-50.

9. Binkiewicz-Glińska, A., Bakula, S., Tomczak, H., Landowski, J., Ruckemann-Dziurdzińska, K., Zaborowska-Sapeta, K., Kiebzak, W. (2015). Fibromyalgia Syndrome-a multidisciplinary approach. Psychiatr Pol. 49(4), 801–810.
10. Calikusu C, Yucel B, Polat A, Baykal C. (2002). Expression of anger and alexithymia in patients with psychogenic excoriation: A preliminary report. Int J Psychiatry Med. 32, 345-352.
11. Demirsoy, A.C. (1999). The Mos SF-36 health survey: A validation study with a Turkish sample (Yayınlanmamış Yüksek Lisans Tezi). Boğaziçi Üniversitesi, Edebiyat Fakültesi, İstanbul.
12. Dökmen Ü., (2005). Sosyometri ve psikodrama. Sistem Yayıncılık.
13. Goldenberg, D. L., Burckhardt, C. and Crofford, L. (2004). Management of fibromyalgia syndrome. JAMA. 292, 2388-95.
14. Goldenberg D.L. (2003). Fibromyalgia and related syndromes. In M. C. Hochberg, A. J. Silman, J. S. Smolen, M. E. Weinblatt, & M. H. Weismann (Eds), Rheumatology (701-712). Mosby.
15. Häuser, W., Glaesmer, H., Schmutzer, G. and Brähler, E. (2012). Widespread pain in older Germans is associated with posttraumatic stress disorder and lifetime employment status- Results of a cross-sectional survey with a representative population sample. Pain. 153, 2466–71.
16. Hudson, J. I., Hudson, M. S., Pliner, L., Goldenberg, D. L. and Pope, H. G. (1985). Fibromyalgia and major depressive disorder: A controlled phenomenology and family history study. Am J Psychiatry, 142, 441-446.
17. Karadağ, F., Oğuzhanoğlu, N.K., Özdel, O., Ergin, Ş., Kaçar, N. (2010). Psöriyazis hastalarında psikodrama: Stres ve stresle baş etme. Anadolu Psikiyatri Dergisi, 11, 220-227.
18. Kavakçı, Ö., Kaptanoğlu, E., Kuğu, N. and Doğan, O. (2010). EMDR fibromiyalji tedavisinde yeni bir seçenek olabilir mi? Olgu sunumu ve gözden geçirme. Klinik Psikiyatri, 13, 143-151.
19. Kellermann P.F. (2013). Psikodramaya derinlemesine bakış (B. Gökler, I. Gökler Danışman, & A. Mavili Aktaş, Çev. Ed.), Psikoterapinin terapötik yönleri içinde (17–32). Nobel Akademik Yayıncılık.
20. Kellerman, P.F., Hudgins, M.K. (2013). Travmadan sağ kalanlarla psikodrama: Acıyı eyleme dökmek (S. Ünal Çev. Ed.). Nobel Yayıncılık, Ankara.
21. Koptagel, İ.G. (1996). Tıpsal psikoloji: Tıpta davranış bilimleri. Ankara: Güneş Kitabevi.
22. Lera S, Gelman S.M, Lopez M.J, Abenoza M., Zorrilla J.G., Castro-Fornieles J., et al. (2009). Multidisciplinary treatment of fibromyalgia: Does cognitive behaviour therapy increase the response to treatment? J Psychosom Re,s 67, 433-41.
23. Lovibond, P. F. & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335-343.
24. Mazzola, A., Calcagno, M. L., Goicochea, M. T., Pueyrredon, H., Leston, J. and Salvat, F. (2009). EMDR in the treatment of chronic pain. Journal of EMDR Practice and Research. 3(2), 66-79.
25. Moreno, J.L. (1993). Who shall survive? Student edition: Foundations of sociometry, group psychotherapy and sociodrama. Roanoke: Royal Publishing Company.
26. Özbek, A., Leutz, G. (2011). Psikodrama, grup psikoterapisinde sahnesel etkileşim. Abdülkadir Özbek Psikodrama Enstitüsü Yayınları.
27. Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. Guilford Press.
28. Solitar B.M. (2010). Fibromyalgia: knowns, unknowns, and current treatment. Bull NYU Hosp Jt Dis 68,157-61.
29. Spaecth, M. (2009). Epidemiology, costs, and the economic burden of fibromyalgia. Arthritis Research & Therapy, 11, 117.
30. Verbunt, J.A., Pernot, D., Smeeths, R.J. (2008). Disability and quality of life in patients with fibromyalgia. Health and Quality of Life Outcomes v.6.
31. Waller E, Scheidt C.E. (2004). Somatoform disorders as disor-ders of affect regulation: a study comparing the TAS-20 with non-self-report measures of alexithymia. J Psycho-som Res, 57, 239-247.
32. Ware J.R., Sherbourne C.D. (1992). The MOS 36- item short form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30, 473-83.
33. Wassem, R., Hendrix, T.J. (2003). Direct and indirect costs of fibromyalgia to patients and their families. Journal of Orthopaedic Nursing, 7, 26-32.
34. Wolfe F, Ross K, Anderson J, Russell Ij, Hobert L. (1995). The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 38: 19-28.
35. Yalom I. (1998). Kısa süreli grup terapileri: İlkeler ve teknikler (N. H. Şahin, Çev.). Türk Psikologlar Derneği Yayınları.
36. Yavuz, F.K. (2012). Fibromiyalji ve somatoform bozukluk hastalarında kişilik özelliklerinin karşılaştırılması (Yayınlanmamış Tıpta Uzmanlık Tezi). Düzce Üniversitesi, Tıp Fakültesi, Düzce.
37. Yılmaz, Ö., Boz, H, Arslan, A. (2017). Depresyon anksiyete stres ölçeğinin (DASS 21) Türkçe kısa formunun geçerlilik-güvenilirlik çalışması. Finans Ekonomi ve Sosyal Araştırmalar Dergisi, 2 (2), 78-91.
38. Yunus M.B. (2007). Fibromyalgia and overlapping disorders. The unifying concept of central sensitivity syndromes. Semin Arthritis Rheum. 36, 339-56.