Have you ever heard someone say “it’s all in your head” when talking about your physical symptoms or discomfort? It’s usually said in a rather dismissive way and the implication is that you are making it up and if you only wanted to, you could make it stop. I thought I would dedicate this post to a discussion on psychosomatic diseases to give you a better understanding of what the term means and how they present.
There is another term to describe psychosomatic conditions that is easier to grasp and less emotionally charged and that is “mind-body syndrome”. This second term is more self-explanatory it makes reference to the idea that your body will react to what your mind believes to be true. Psychosomatic disorders are really one version of a broader group of entities called psychogenic disorders which is defined as “any physical disorders induced of modified by the brain for psychological reasons”.
Some of these manifestations will sound very familiar to you blushing when you feel embarrassed, sweating when you are put on the spot, butterflies in your stomach when you are anxious. These all seem harmless and more importantly temporary, persisting only as long as the original stimulus remains.
A second group of psychogenic disorders is when a physical disorder is intensified by stressors that are unrelated to the condition. An example may be the increased physical pain felt by some after a car accident when confronted with everyday stressors in daily life, be it from work, family etc. but not related to the injuries themselves. An example might be the pain getting far worse after a fight with your spouse, technically no additional damage has been done to the spine or muscles but the stress of dealing with an additional stressor exasperates de symptoms. Generally speaking mainstream medicine tends to ignore almost all psychogenic manifestations but this one in particular they do acknowledge, recognizing that symptoms appear worse when the patient is anxious and it’s refereed to as “emotional overlay”. In some cases, after receiving MRI results patients reported that their pain became much more severe.
The third psychogenic group reverses the second. Henry Beecher from Harvard reported on this with a group of baldy wounded soldiers in World War II. It was found that no matter how severe their injuries they often “required little or no analgesic medication because their pain was substantially lessened by their becoming aware that they were still alive, being cared for and removed from the dangers of deprivation, hardship, and sudden death.” Imagine that! Being so grateful about both being alive and not to having to return to the front lines that your pain tolerance is much higher!
The fourth group is know as hysterical disorders and they are often quite strange. The patient may suffer from a wide variety of debilitating symptoms, including muscle weakness or paralysis, numbness or tingling, or a complete absence of sensation, blindness, inability to speak, among others, all of this without any physical abnormalities to speak of in the body to account for the symptoms, which in turn indicates that they are generated by powerful emotions in the brain. The person perceives them as originating in the body. One 19th Century pioneer of psychiatry Josef Breuer compared them to hallucinations.
The fifth group and our point of interest is psychosomatic disorders. This one stands out in that the brain induces actual physical changes in the body to account for the disease. An interesting note about both Hysterical and Psychosomatic disorders is the tendency for them to become in vogue and spread throughout the population as if they were bacteriological in nature. Perhaps you have noticed how we go from a non-existent disease to one that a large percentage of the population suddenly suffers from, for instance irritable bowel syndrome, tension headaches etc. As weird as it sounds people with an unconscious psychological need for symptoms tend to develop a disorder that is well known like back pain, allergies or eczema. Some schools of thought say that it’s related to current and past emotional states whereas others say it’s simply a way for your subconscious mind to distract your conscious mind from thoughts, beliefs or fears that seems to overwhelming to handle for the moment. The truth may lie somewhere in between.
The problem with mind-body syndromes is that there is a stigma associated with it. This isn’t new. For a long time certain diseases have been a reason for shame, it used to be that way with tuberculosis. Often this is still the case with mental health conditions. As if you had made a deliberate choice to be sick. There have been many efforts recently to end the stigma associated with mental health conditions but it seems to be human nature to ostracize that which we don’t understand.
To really understand the concept of our subconscious mind trying to distract us from something we need to understand how suppression vs repression works. Suppression is a conscious choice to not think or deal with something. It’s also known as denial. Sometimes we lie to ourselves and pretend we are “over it” but really we are just suppressing it. Repression on the other hand is something that is completely out of our awareness, by definition we don’t know it exists.
Here’s an example: We have a fight with a friend or family member, in the heat of the moment hurtful “truths” are said and we are called “manipulative”. We suppress the anger and pain (we consider ourselves very kind, generous and selfless, being called manipulative is enraging), we accept their apology, but there is no discussion of what was said or if it was meant, it’s now just “water under the bridge”. As a result there is a part of us that always remembers what they said and the relationship is never quite the same, after all they believe us to be “manipulative”. Suppression.
Simultaneously, our subconscious is aware of the reality that because we feel inherently unworthy we do have a tendency to over-do for others in an effort to remain relevant, loved and to prevent abandonment. When our effort and sacrifices are not acknowledged or reciprocated we do in fact engage in manipulative behavior. Recognizing that reality would challenge our self image and identity as good, honorable people. It’s too much to bare it must be kept from us at all cost. Repression. So when our minds start thinking about that comment “you are manipulative” our subconscious quickly attempts to distract us with be it a “random” headache or sudden back pain.
An interesting point about psychosomatic conditions is that they come and go seemingly at random. Unlike a fractured bone that continues to hurt consistently until it heals a mind-body disease comes and goes. The pain can be excruciating one minute and nonexistent the next; once you have been appropriately distracted from the issue, the symptom is no longer necessary.
For an in-depth discussion on Psychosomatic diseases please refer to Dr. John E Sarno M.D.’s book “The Divided Mind”. In it you will also find a treatment protocol he has used to resolve these “incurable” diseases.