Problem:
Ms. j age 42 years, has been coming to the mental health clinic for 2 years for her nerves. she has only seen her primary healthcare provider for prescription medication. the care provider referred her to the nurse's new "stress management group" because she is experiencing side effect of all the medications that have been tried. the psychiatrist has diagnosed somatic disorder and wants her to learn to manage her nerves without medication. at the first meeting with the nurse, Ms. was preoccupied with chest pain and bloating that had been ongoing for the past 6 months. her chest pain is constant and sharp at times. the pain does not prevent her from going to her job but does interfere with meal preparation at night for her family and her ability to have sexual intercourse. she has numerous other physical problem, including allergies to certain perfumes, dysmenorrhea, ovarian polycystic disease, chronic urinary tract infection, and rashes. she is constantly fatigued and has frequent leg cramps. she states that she is too tried to prepare dinner for her family. on days off from work, she takes a nap in the afternoon, sleeping until evening. she is unable to fall asleep at