This is such a complex topic.

I lived for many years with a partner who had a multitude of physical and psychological disorders. In the beginning, I was convinced that her chief problem was not getting the consistent, focused medical care she needed to address her medical issues, and I put myself in charge of helping her get to the bottom of things and get some real treatment.

Over time, through agonizing years of one step forward, two steps back, it became apparent that her mental and physical symptoms were so intertwined and interrelated, it was impossible to determine causality or even the "reality" of her complaints. Even the dramatically visible ones--seizures, disassociation, extreme pain, lack of muscle control--were almost capricious in their manifestation. There was no way to untangle each thread and give her the help she needed, in part because she was unable to face the deep psychological nature of some of her problems and refused treatment on that front.

She lives somewhat on her own now, in poverty, sickness, and hopelessness. Our medical system can't/won't help her, and our mental health system is so deeply F'ed up that she doesn't get what she needs there, either.

While I would never "blame" her for her troubles, there is no doubt in my mind that many of her medical issues have psychosomatic origin. It happens, it's real, and it's the source of incredible pain and frustration to both professionals and loved ones alike.

Edited to add: I have great sympathy for her individual therapists, as she is a convincing liar (who believes most of what she says) and makes it very difficult to get to the "truth." It took me many years to figure things out, and I lived with her and was very focused on her problems. Someone seeing her an hour a week was at a real disadvantage.