Somatisation: Understanding the Link Between Emotions and Unexplained Physical Symptoms
- Sasha Javadpour
- Apr 3
- 5 min read
Updated: Apr 3
Have you ever experienced persistent headaches, stomach issues, or body pain that medical tests couldn’t explain? If so, you’re not alone. Many people go through distressing physical symptoms without an identifiable medical cause. This is known as somatisation—the process where emotional or psychological struggles manifest as physical discomfort.
Somatisation doesn’t mean the symptoms aren’t real. In fact, they can be just as painful and disruptive as symptoms caused by physical illnesses. The key difference is that their root cause lies in unprocessed emotions, stress, or anxiety rather than a medical condition. Not being aware of this often leads to frustration, as individuals undergo multiple medical tests only to be told that "we can't find anything physically wrong with you"
Common results of Somatisation include:
Chronic pain
Digestive issues
Fatigue
Dizziness
Muscle tension
While these symptoms may appear random, they are often the body’s way of signaling unresolved emotional distress. Recognizing this connection is the first step toward finding relief and addressing the underlying causes.
In this article, we’ll explore what somatisation is, how psychological factors can lead to physical symptoms, and how therapy can help individuals manage and overcome these challenges. We will also dive into how therapy can identify the root causes of somatisation and guide you towards healing.
Content:
What is Somatisation?
Somatisation refers to the experience of physical symptoms that have no clear medical cause but cause significant distress and impairment. These symptoms can range from chronic pain and gastrointestinal issues to neurological disturbances like paralysis or seizures. While the symptoms are real and often severe, their underlying cause is psychological rather than purely physiological. Somatisation can take various forms.
The different types of somatisation include:
Somatic Symptom Disorder (SSD): Individuals experience persistent and distressing physical symptoms, such as chronic pain, fatigue, or gastrointestinal issues, that may not have a clear medical explanation. What distinguishes SSD from general bodily discomfort is the excessive worry, catastrophic thinking, and emotional distress surrounding these symptoms. People with SSD often feel their symptoms are more serious than doctors suggest and may repeatedly seek medical reassurance, which temporarily reduces anxiety but ultimately reinforces the preoccupation with illness.
Illness Anxiety Disorder (formerly hypochondriasis): This involves a persistent fear of having or developing a serious illness, even when medical tests show no cause for concern. Unlike SSD, where the focus is on existing physical symptoms, people with illness anxiety disorder are primarily worried about what might happen. This heightened state of vigilance can make them hypersensitive to normal bodily sensations, interpreting them as signs of severe illness. Anxiety itself can also trigger real physical symptoms—such as dizziness, nausea, or palpitations—creating a cycle where fear reinforces the very symptoms they dread.
Conversion Disorder (Functional Neurological Symptom Disorder): This condition involves sudden, unexplained neurological symptoms, such as paralysis, tremors, seizures, blindness, or difficulty speaking, that cannot be traced to a medical cause. These symptoms often emerge following extreme stress, emotional trauma, or psychological conflict. Unlike malingering, where symptoms are faked for external gain, people with conversion disorder are not consciously producing their symptoms. Instead, the mind converts psychological distress into physical dysfunction, often affecting movement, sensation, or perception in ways that mimic neurological diseases.
Psychological Factors Affecting Other Medical Conditions: Here, a diagnosed medical condition—such as heart disease, irritable bowel syndrome, or chronic pain—is significantly worsened by psychological distress or maladaptive behaviours. Stress, anxiety, and depression can amplify symptoms, delay healing, or lead to poor health decisions, such as neglecting medication or engaging in risky behaviours. For example, a person with high blood pressure may experience worsening symptoms due to chronic stress, or someone with asthma may have frequent attacks triggered by anxiety.
Factitious Disorder: Unlike other forms of somatisation, factitious disorder involves deliberately faking, exaggerating, or even inducing symptoms—either in oneself or in someone else (known as factitious disorder imposed on another, previously called Munchausen syndrome by proxy). The key distinction is that the person’s motivation is not financial gain or legal advantage but a deep psychological need to assume the sick role. Some may go to extreme lengths, such as tampering with medical tests or undergoing unnecessary procedures, to sustain the appearance of illness.
People with somatisation often experience high levels of health-related anxiety, frequent medical visits, and frustration with inconclusive test results. Some may go from doctor to doctor, seeking validation for their symptoms, while others may avoid medical care altogether out of fear of a serious diagnosis. Despite reassurances, they remain preoccupied with their symptoms, sometimes to the point of significant life disruption. In more extreme cases, individuals may unknowingly or intentionally produce symptoms, as seen in factitious disorder. Regardless of the specific presentation, somatisation is deeply tied to stress, trauma, and emotional distress, making psychological support essential for managing symptoms and improving quality of life.
How Psychological Issues Lead to Physical Symptoms
The mind and body are closely linked, and psychological distress can cause real physical symptoms.
Chronic stress, anxiety, and emotional trauma trigger the release of stress hormones like cortisol and adrenaline, keeping the body in a heightened state. This can lead to persistent issues like headaches, muscle tension, dizziness, digestive problems, heart palpitations, and chronic pain. Conditions like irritable bowel syndrome (IBS) and migraines show how emotional distress affects the body.
Another factor is heightened bodily awareness. People with health anxiety or somatic symptom disorder often misinterpret normal sensations—like mild chest fluttering or nausea—as signs of serious illness. This anxiety worsens symptoms, creating a cycle of distress. In conversion disorder, emotional distress can "convert" into neurological symptoms like paralysis or seizures after trauma.
Psychological issues can also worsen existing medical conditions by increasing inflammation, impairing immunity, and delaying healing. For example, emotional stress can lead to more frequent chest pain in those with heart disease or flare-ups of fibromyalgia. Distress can also cause poor health behaviors like neglecting treatment or avoiding exercise, which worsen health problems. Recognizing the link between emotional distress and physical symptoms is key to effective treatment, which may include therapy, stress management, and lifestyle changes.
How Therapy Can Help Address Somatisation
If you're dealing with somatisation, therapy can help you understand the connection between your physical symptoms and your emotional well-being. By exploring your thoughts, feelings, and experiences, therapy can guide you in managing the emotional factors that may be triggering your physical symptoms. Here's how therapy can support you:
Identifying the root causes: Therapy helps uncover the emotional or psychological issues that may be contributing to your physical symptoms, whether it’s stress, anxiety, or past trauma.
Learning coping strategies: Therapy teaches techniques to manage stress, such as relaxation exercises, mindfulness, and deep breathing, which can help reduce the physical impact of emotional distress.
Processing emotions: Working with a therapist allows you to express and work through suppressed emotions, reducing the physical toll caused by holding onto unprocessed feelings.
Changing thought patterns: A therapist can help you recognize and challenge negative thought patterns that may be intensifying your physical symptoms, leading to healthier ways of thinking and reacting.
By addressing both the mind and the body, therapy can guide you toward healing, helping you manage and reduce the impact of somatisation on your life.
Healing Begins When You Start Listening to Your Mind and Body
Somatisation is a complex and often misunderstood phenomenon where psychological issues trigger real physical symptoms. By understanding the connection between the mind and body, individuals can begin to address the emotional roots of these symptoms and find relief. Therapy offers a valuable path to healing, allowing individuals to manage stress, process emotional trauma, and reduce the impact of these symptoms on daily life.
At Hirsch Therapy, we understand the nuances of somatisation and are here to help you work through the underlying psychological factors causing your physical distress. If you’re struggling with unexplained symptoms, we offer a 15-minute free online consultation to ensure a good therapeutic fit and explore the ways we can help you achieve balance and healing.
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