Somatization – also known as somatic symptom disorder and conversion disorder-happens when emotional stress or inner conflict shows up in physical ways. It’s a powerful example of the mind-body connection. Everyone experiences somatization to some degree. For example, we’ve all had butterflies in our stomach when nervous. But in some cases, symptoms become so persistent and excessive that they seriously affect a person’s daily life and well-being.
Treatment of somatization is one of my specialties, and I’ve seen many different forms of it. In this blog, I want to talk about a particularly complicated situation, where people experience somatization along with an organic illness. I’m going to outline two common scenarios where this can happen. Both are challenging for clients, loved ones and healthcare providers, but they’re also quite treatable. The key is recognizing what’s happening.
WHEN SOMATIC SYMPTOMS MIMIC A DIAGNOSIS
One scenario we see is somatic symptoms that mimic a diagnosed organic illness. For example, I’ve worked with a client who had epilepsy, but who also experienced non-epileptic seizures (PNES- Psychogenic Non-Epileptic Seizures). The extraordinary thing in this case, is that we can get a firm diagnosis by monitoring brain patterns. Since we know what the brain looks like during an epileptic seizure, if a person has an event that doesn’t match those patterns, we know it is non-organic in nature.
How can this happen? The explanation is actually quite straightforward. Remember, somatization is the body’s response as your mind tries to process difficult emotions and situations. So in that moment of emotional distress, your body goes to the familiar expression that it knows. In this case, a seizure. Here’s how I think about it: Often, when a woman is pregnant for the second or third time, she starts to look very pregnant early on. Her body knows what’s coming, and just follows the pattern.
In a related scenario, I’ve also seen situations where a family member is quite sick, and someone else experiences somatization that mimics those symptoms. For example, I saw a family where the mom had serious post-concussion symptoms, and the teen daughter experienced the same symptoms without a concussion event. Again, in moments of deep emotional distress, her mind & body went to familiar patterns-not ones she’d felt, but ones she’d witnessed.
WHEN SOMATIC STRESS ADDS NEW SYMPTOMS
People living with a chronic illness, such as diabetes or epilepsy, often have to reimagine their lives or reconcile things they’ve lost. Not surprisingly, this can lead to serious emotional stress. That’s when the body can amplify this mental distress into somatic symptoms. One of the most common ways is with unexplained pain. For example, this can happen with fibromyalgia, where a person thinks their illness is getting worse, but it’s actually somatic pain amplification.
In these cases, patients are often surprised that this is happening-or that it even can happen. Since the symptoms have gotten so severe, they can’t imagine it’s anything but an illness. It can be quite hard for people experiencing this (let alone the general public) to understand and accept, but this new pain isn’t medical, and it’s not mental—it’s both. After all, if a person can have both physical pain and a mental illness like depression, there’s no reason someone can’t have fibromyalgia and somatic pain. As a mental-health professional, it’s my role to figure out what the stress is, help the client express it, and bring that pain amplification down. If stress and distress can increase pain, acknowledging and expressing stress and distress can decrease it as well.
Both of these situations are vivid examples of the mind-body connection. It’s vital to understand that they really are one and the same. The mind and the body work together to process distress, stress and difficult emotions, often in the way that’s most readily available.
There is no doubt that untangling the experience of a person living with both an organic illness and somatic symptoms is challenging, but today we understand this extraordinary mind-body connection better than ever. With the right support and care, most people going through it experience significant improvement and can ultimately return to their daily lives.
Anu Chahauver is the Director of Your Therapy and a registered social worker and psychotherapist. Anu specializes in seeing individuals, couples, and families. Anu has expertise in somatization, medical & mental health. Anu’s practice is evidence-informed using Narrative,CBT, Attachment, Internal Family System, and Emotionally Focused therapies.
Your Therapy is a safe, welcoming counselling therapy practice in the Greater Toronto Area. Thanks for reading and, as always, please feel free to reach out with questions about talk therapy or other mental health issues. We offer mental health therapy and more.
