Somatization (Psychological pain manifested through the body.)

Somatic Symptoms 

Comments from Barbara Burrows
A number of my  patients have experienced serious symptoms that turned out to be somatic (psychological pain manifested through the body) – including temporary loss of vision, seizures and the ticking of Tourettes Syndrome. In these three specific cases and in most of my other cases with somatization , talk (psychodynamic)  therapy resolved the symptoms.  Although studies show psychodynamic treatment offers lasting change, (Shedler 2006,) (see is psychoanalysis effective) people may not have the time or money to attend 2-5 therapy sessions/week for a number of years and clinicians trained psychodynamically (psychoanalytically) are not readily available.

Expressive writing  may offer an option for those unable to access psychodynamic treatment.

Work of Allan Abass Dr. Allan Abbass is professor, psychiatrist, and founding Director of the Centre for Emotions and Health at Dalhousie University in Halifax, Canada. Dr. Abbass’s clinical specialty and research focus is the use of Short-Term Dynamic Psychotherapy. The following is taken from his book “Reaching Through Resistance”

Common ways anxiety manifests in somatic symptoms:  Often people can know intellectually that they have a certain feeling and can speak about the feeling, but the affect is isolated from his experience and discharged into the striated muscles.  Isolation of affect is a major defense.

[1] #1 Striated-muscle-related presentations:

Tension headaches
Chest pain
Jaw pain, teeth grinding
Shortness of breath
Choking sensations
Abdominal pain
Vocal and other tics
Leg pain
Neck Pain
Back pain
 #2 Smooth (Involuntary) Muscle Unconscious Anxiety

Table 2.2 [2]

Smooth-muscle-related condition
Medical Specialty Smooth Muscle related condition
Cardiology Hypertension, coronary spasm, flushing, hypotension with loss of consciousness
Respirology Asthma, coughing, choking symptoms
Gastroenerology Irritable bowel, gastroesophageal reflux disease, functional vomiting, unexplained abdominal pain
Urology Bladder dysfunction, interstitial cystitis
Neurology Migraine

#3 Cognitive Perceptual Disruption

Visual blurring, visual loss, tunnel vision
Hearing impairment or loss
Memory loss
Loss of consciousness
Hallucination in all five senses[3]

#4 Conversion A patient defends  against his anxiety by becoming “relaxed” – all his muscles go slack and can even become paralyzed – but the person seems relieved at the same time.

[1] Reaching Through Resistance Allan Abbass P 14

[2] Reaching Through Resistance Allan Abbass P 14

[3] Reaching Through Resistance Allan Abbass P 17