It appears as of this morning, that Lubitz, the Germanwings copilot responsible for the crash in the Alps, was reported as suffering from a “psychosomatic illness.” Just what does that mean? Well, to put it in the simplest terms, it means that his emotions were affecting his physical functioning. For example, stress is well-known to have many physical effects. It is a strong contributor to Irritable Bowel Syndrome. What it does not mean is that it was a “made up” or imaginary illness. As a sufferer of IBS, I can tell you that my multiple trips to the bathroom are not imaginary! 😀

Wikipedia provides this definition (seemly derived from DSM 5): A somatic symptom disorder, formerly known as a somatoform disorder, is a mental disorder characterized by physical symptoms that suggest physical illness or injury – symptoms that cannot be explained fully by a general medical condition or by the direct effect of a substance, and are not attributable to another mental disorder. There are several somatic symptom disorders recognized in DSM 5 (Diagnostic and Statistical Manual, edition 5). In essence this definition means that Lubitz likely was presenting with at least one physical symptom that was not explained by a physical cause. We don’t know what symptoms he was reporting.

Just what the nature of Lubitz’ problems were is still unknown. And that’s important here. We just don’t know. I’m sure that the various investigators are looking into what was going on with this young man. But if they want to be thorough and come up with as accurate picture of what was going on with him, then it will take time. This, of course, is a problem for the media which needs to have a near-constant stream of new material, but this is the reality here. Diagnosis of a mental condition is difficult enough in a clinical setting with a cooperative (and alive) patient. And in this case, the investigators aren’t just looking for a diagnosis, but for the reasons for a specific act.

UPDATE 3/30/15:  Heard some psychologist on CNN saying that the reported psychosomatic illness suffered by Lubitz indicated that he was not in touch with reality and that he was psychotic. That’s just plain wrong.

It seems that Lubitz was having visual problems, but docs couldn’t find an organic reason for those problems so suggested that it was psychosomatic. Okay, that can happen. Think back to old WWII movies and soldiers suddenly unable to see but there are no physical wounds. That used to be called “hysterical blindness.” It doesn’t happen as much any more, but it does occur. But, it does not mean the patient is psychotic or out of touch with reality. It means that the psychological stress and upset the patient is suffering from is manifesting through the visual system.

I am also concerned about just who called this a psychosomatic illness. Was it the eye doc after finding nothing physically wrong with Lubitz’s eyes? Hmm. Reminds me of many, many years ago when I was complaining of pain in my knee. This was before CAT scans or MRIs, so when nothing showed up on X-Rays, the orthopedist called it psychosomatic, a way to get out of phys ed at school. Jump forward a couple years and another orthopedist decided to do surgery since at that point I’d been having pain for quite a number of years. Lo and behold, he found a torn cartilage. Bottom line: just because a doc doesn’t find something physically wrong doesn’t mean necessarily that it’s “all in your head.” Thank goodness my docs never suggested that I was psychotic. I wasn’t.

I’d need a lot more information to say whether or not Lubitz was psychotic in the past or at the time of the crash. Just because someone labeled him as suffering from a psychosomatic disorder DOES NOT make him psychotic!