Somatisation refers to the expression of physical symptoms that cannot be explained by an organic cause; in other words, symptoms that do not correspond to any identifiable, detectable illness or condition in the body.
Although many people find it hard to believe, one of the body’s functions is to act as an alarm for our emotional world. This means that physical pain can sometimes be caused by emotional distress that has not been resolved and is being expressed through the body, telling us that something in our emotional world needs our attention. Somatisation, therefore, highlights the connection that genuinely exists between body and mind.
We can see evidence of this connection in the fact that, when we experience an emotion such as sadness, it triggers a set of physical reactions in our body, such as crying. Continuing with this example, we can think of tears as the body’s way of expressing an emotion – in this case, sadness. Crying has been shown to be neither a random nor a meaningless reaction. Quite the opposite. Tears calm us down thanks to the release of oxytocin and endorphins, producing a feeling of physical and emotional relief. It is common to feel tired and sleepy after a good cry. Crying helps us release the emotional load of our sadness, just as the body releases each tear, and that release allows us to rest.
Physical symptoms obviously bring about changes in the daily life of the person experiencing them. They prevent them from doing things they would like to do as normal, affect their relationships with others, reduce their performance at work, and so on. When this happens, it is only natural for the person to focus on these physical symptoms and try to understand their cause in order to find a remedy. Their worry usually grows when, after several tests and appointments with different specialists, nobody seems able to work out what is wrong. In this scenario, it is common to hear remarks such as “it might be your nerves, try to relax”, which is really just a trivial way of saying “your discomfort may have an emotional cause”. It is when we are willing to accept the connection between body and mind that we can shift our focus: we stop concentrating on the symptom itself and start discovering what the symptom is trying to tell us.
A somatic symptom, like any psychological symptom, has a function. As I mentioned earlier, physical symptoms hold the person back. Somatisation stops them from carrying on with what they were doing and forces them to turn their gaze inwards, towards themselves, and examine what is happening to them, because the body is signalling that something is wrong. This symptom – which is no less real for being somatic – has come to do what the person has not been able to do for themselves: stop and reflect.
I like to say that somatisation acts like a warning light on a car dashboard, which comes on when it detects that something is not working properly. The light tells us we need to stop, take the car to the garage and fix whatever is wrong before carrying on. Unfortunately, we all know plenty of people who decide to keep driving and ignore the warning, until one day, when they least expect it, the car breaks down and leaves them stranded at the worst possible moment. Somatic symptoms work in a very similar way.
Body and mind are wise. Paying attention to the warning light (the somatic symptom) may not always be easy, because it can mean coming face to face with a series of unpleasant emotions that the person is unconsciously trying to avoid at all costs. Missing an appointment can trigger guilt at feeling that you are letting others down; performing less well at work can lead to a sense of failure; not being able to do something you want to do can cause frustration, and so on. These are just a few examples of the beliefs and emotions linked to doing (or rather, not doing) activities in different areas of a person’s life that can lead to suffering.
When managing these emotions becomes too complicated or painful, somatisation appears as a defence mechanism against them, leading the person to place all their attention on the symptom instead of facing those emotions. The focus stays on the outside, on the physical pain that now prevents them from carrying on as normal. The person plays the role of the patient and waits for the doctors to provide a solution, convinced that the cause of their complaint lies in the body, and never for a second considers turning their focus inwards – that is, towards the mind. So, while these emotions remain unresolved, hidden behind the physical symptom that takes up all the attention, the symptom persists like an alarm that will not stop ringing, constantly signalling that something is wrong. Somatisation tries to avoid the emotion, because the emotion is more painful to face than the physical pain itself.
In conclusion, having set all this out, it is worth stressing how important our interpretation of the body’s expressions is when it comes to understanding physical symptoms. This reading of the symptom is the foundation for understanding how we ourselves work and for being able to heal both body and mind. We need to learn to tell the difference between when a physical symptom may point to an illness, injury or disease, and when it may be acting as a sign of unresolved emotional distress. In other words, we need to learn to read what the body is expressing.
