None of our patients reported that a bodily abnormality or clinical somatic diagnosis had been discovered during the follow-up period that accounted for their dissociative symptoms.
Of particular interest, is that since half of individuals with PCD have situs inversus, a physical but concealable bodily abnormality, decisions have to be made about revealing this atypicality to others [ 15].
This is highly fortunate trait, because throughout my career I will encounter all forms of gore, bodily fluids, and skin abnormalities.
The phenomenology of DPD is complex, encompassing abnormalities of bodily sensation (typically, reduced sensation or even a sense of complete disembodiment) and emotional experience (diminished subjective and autonomic responsivity to emotional stimuli or events, perhaps implying some overlap with the concept of alexithymia, discussed above) (Sierra et al. 2002, 2005; Simeon et al. 2008).
Various mechanisms may contribute to somatization, including sensitisation of the brain to bodily sensations [ 13], physiological abnormalities in the nervous and endocrine systems [ 14], heightened awareness of bodily sensations [ 15], and inappropriate illness beliefs and sickness behaviour [ 16].
In Rhys' case, the abnormality of his bodily functions led him to seek help from his doctor.
So to call something a disease involves both a claim about the abnormal functioning of some bodily system and a judgment that the resulting abnormality is a bad one.
The clinical specialty of plastics typically draws a distinction between 'reconstructive' surgery (the correction of abnormality) and 'cosmetic' surgery (altering bodily appearance of patients presenting "within the range of normality") [ 26].
Importantly, the insula is activated during sexual arousal (Arnow et al. 2002; Karama et al. 2002) and its dysfunction is related to sexual behavior abnormalities (Miller et al. 1986) and bodily self-consciousness (Heydrich and Blanke 2013).
Technical factors, such as the specific imaging protocol used, the use of appropriate contrast or patient bodily habitus may influence the radiologist's ability to identify abnormalities or to correctly interpret them [20].
