Hammer and Nail Medicine: The Pervasive Ignorance of Endometrial Pain in Adolescents by the Mental Healthcare Profession

In: Endometriosis in Adolescents · 2020 · pp. 367–385 · doi:10.1007/978-3-030-52984-0_19 · W3101790482
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Mental healthcare often invalidates and misdiagnoses adolescent endometriosis, leading to delayed diagnosis and reliance on behavioral health services due to insufficient training and interdisciplinary communication.

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This chapter discusses how mental and behavioral healthcare professionals may fail to recognize endometrial pain—particularly in adolescents—leading to normalized or invalidated experiences, delayed diagnosis, and misdiagnosis. It argues that situational powerlessness and isolation in the context of undiagnosed endometriosis can suppress pursuit of gynecological care, while emotional dysregulation and mood lability can instead trigger referral to mental health services, with insufficient training and weak coordination with physicians cited as key limitations. A major caveat is that the work presents a conceptual account of “collective causes” and associated costs, rather than reporting original empirical data or specific study results. This paper is centrally about endometriosis — it focuses on the mental healthcare profession’s failure to identify endometriosis-related pain and how that oversight contributes to delayed diagnosis in adolescents.

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Abstract

Mental/behavioral healthcare continues to supply a covert nourishment of the suffering in adolescents and women afflicted with endometriosis. In adolescents, the situational powerlessness is primary. In normalizing the pathology of painful endometriosis, when the isolation affects the adolescent without interfering in the family’s functioning on a day-to-day basis, it often results in gynecological care not being sought. Instead, when dysregulated emotions from the many compounding factors in undiagnosed endometriosis lead to mood lability, this often causes familial dysfunction severe enough to warrant mental healthcare. Problematic is the absence of a psychotherapist’s ability to identify underlying causes of dysregulation and dysfunctional emotional health, especially when due to endometriosis or other reproductive system disease; this is a direct function of both insufficient training and a connective tissue disorder between the professional counselor and the multitude of physicians required for holistic care in the female adolescent with pain and depression. As such, delayed diagnosis and misdiagnosis become side effects of the routine invalidation of the patient’s experience, regrettably leading to (often lifelong) a habituated, recurrent dependency on the behavioral healthcare system. We look at the collective causes, environmental supporting mechanisms, and the costs of incorrect and untimely diagnosis in and perpetuated by mental and behavioral healthcare. Most importantly, to the extent that mental/behavioral healthcare is involved, we outline solutions to prevent further suffering due to undiagnosed endometriosis. The limits of my language means the limits of my world. Ludwig Wittgenstein Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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