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Migraine Treatment: From Purely Physical to Psychosomatic


The perception of migraine has changed significantly over time. Originally, migraine was seen as a purely somatic disorder whose causes and treatment methods were sought exclusively in the physical realm. This understanding was mainly characterized by limited diagnostic possibilities and a low awareness of the complexity of body-mind interactions. Medical research focused on the visible, measurable symptoms and neglected the deeper psychological and emotional factors.


Man with a headache touching his forehead.

However, with advances in neurology and psychology, as well as interdisciplinary research approaches, the concept of migraine has broadened. Today, it is recognized that migraine is a multifactorial disease in which both biological and psychosocial factors play a role. This realization has led to a more holistic view of the disease and its treatment, taking into account both somatic and psychosomatic aspects.



Studies and results on the relationship between migraine and stress


Research has shown that stress can be a major trigger for migraine attacks. Studies such as the one by Peterlin et al. have investigated the link between stress and the increase in migraine frequency and intensity and found that stress management techniques can reduce the frequency of migraine attacks. These findings emphasize the need to include psychological factors such as stress, anxiety, and depression in the treatment of migraine.



Bodymind Therapy (BMT): A systemic body psychotherapy for migraine treatment


BMT, also known as systemic body-oriented psychotherapy, offers an integrative approach to the treatment of migraine. This form of therapy takes into account the interactions between body and mind and aims to improve the patient's self-awareness and self-regulation. Using techniques from biofeedback, relaxation exercises, mindfulness meditation, and cognitive behavioral therapy, BMT helps patients cope with stress, process emotional stress, and thus reduce the basis for migraine attacks.


BMT assumes that mental states can have direct physical effects and vice versa. By working at the interface between body and mind, it offers a promising approach for migraine patients who suffer from both the physical symptoms and the psychological stress of the condition. This form of therapy not only promotes the management of migraine itself but also contributes to an improved quality of life by providing patients with tools to deal with stress and other triggers more effectively.



What does it look like in practice?


The therapies presented can be grouped into the following categories to provide an integrative approach to the treatment of migraine:


Physical

  • Self-awareness therapy: Here, patients learn to consciously control physical processes such as heart rate and muscle tension, which can contribute to migraine prevention.


  • Relaxation techniques: Techniques such as progressive muscle relaxation, breathing exercises, and yoga help to relax the body and reduce stress, which is often a trigger for migraines.


  • Lifestyle changes: Advice on diet, sleep, and physical activity supports a healthy balance that can influence migraines.


Emotional

  • Psychodynamic and systemic therapy: This therapy helps to explore and process unconscious conflicts and emotional wounds that can lead to psychosomatic symptoms such as migraines.


Mental

  • Belief work: This phase of therapy focuses on recognizing and changing negative thought patterns that can contribute to stress and migraines, and encourages the development of coping strategies for stress.


  • Stress management training: By learning effective techniques for dealing with stressors in everyday life, patients can reduce the frequency of migraine attacks.


Coaching for everyday life

  • Time management training and lifestyle changes also fall under this category, as they provide patients with practical tools to deal with everyday challenges that can trigger migraines. The aim is to develop effective strategies for time management, prioritization, and learning true needs-based planning that can be applied directly to everyday life to promote a healthy balance and minimize stress.



Conclusion

At a time when there is a growing understanding of the complexity of health and illness, the evolution of migraine treatment from a purely physical to a psychosomatic approach demonstrates the importance of a holistic approach to medical challenges. Considering both the physical and psychological dimensions offers new perspectives and treatment options for migraine patients and underlines the importance of an integrative approach to health.



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Sources


Psychosomatic causes: The study shows that stress and emotional disturbances contribute significantly to migraine, and techniques such as biofeedback and cognitive therapy can be helpful. Masahiro Hashizume


Neurophysiological perspective: Research suggests a role of dysregulation between the arousal unit and the executive system in migraine, accentuated by a lack of habituation.

Vincenzo Guidetti, Noemi Faedda & Michael Siniatchkin


Migraine and trauma: The article explains how trauma and psychological features such as anxiety are associated with migraine, including through dysregulation of the HPA axis and autonomic system. Jean Kim, M.D.


Allostatic load and migraine: The study shows that higher levels of the Bologna Allostatic Load Index (BALI) correlate with an increase in the frequency of migraine attacks, suggesting migraine as a maladaptive stress response.

Calogero Calabrò, Eliana Di Tillo, Umberto Pensato, Corrado Zenesini, Valentina Favoni, Camilla Fontana, Sabina Cevoli, Eliana Tossani, Pietro Cortelli, Silvana Grandi & Giulia Pierangeli

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