Somatization is a tendency to experience and communicate psychological distress in the form of bodily and

organic Organic may refer to: * Organic, of or relating to an organism, a living entity * Organic, of or relating to an anatomical organ Chemistry * Organic matter, matter that has come from a once-living organism, is capable of decay or is the product ...

symptoms and to seek medical help for them. More commonly expressed, it is the generation of physical

symptoms Signs and symptoms are the observed or detectable signs, and experienced symptoms of an disease, illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormali ...

of a

psychiatric condition A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

such as

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

. The term somatization was introduced by

Wilhelm Stekel Wilhelm Stekel (; 18 March 1868 – 25 June 1940) was an Austrian physician and psychologist, who became one of Sigmund Freud's earliest followers, and was once described as "Freud's most distinguished pupil". According to Ernest Jones, "Stekel ...

in 1924. Somatization is a worldwide phenomenon. A somatization spectrum can be identified, up to and including at one extreme

somatization disorder Somatization disorder is a mental disorder, mental and Abnormal behavior, behavioral disease#Disorder, disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic nervous system, somatic symptoms. It ...

Related psychological conditions

Somatization can be, but is not always, related to a psychological condition such as: *

Affective disorder Affect, in psychology, refers to the underlying experience of feeling, emotion or mood. History The modern conception of affect developed in the 19th century with Wilhelm Wundt. The word comes from the German ''Gefühl'', meaning "feeling." ...

s (anxiety and depression) *

Somatoform disorder A somatic symptom disorder, formerly known as a somatoform disorder,(2013) dsm5.org. Retrieved April 8, 2014. is any mental disorder that manifests as physical symptoms that suggest illness or injury, but cannot be explained fully by a general ...

s The

American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are involve ...

(APA) has classified somatoform disorders in the

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...

and the

World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

(WHO) have classified these in the

ICD-10 ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, ...

. Both classification systems use similar criteria. Most current practitioners will use one over the other, though in cases of borderline diagnoses, both systems may be referred to. In spite of extensive research over the last 20 years, researchers are still perplexed by somatoform disorders.

Ego defense

psychodynamic theory Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...

, somatization is conceptualized as an

ego defense In psychoanalytic theory, a defence mechanism (American English: defense mechanism), is an unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and ou ...

, the unconscious rechannelling of repressed emotions into somatic symptoms as a form of symbolic communication (

organ language According to the psychoanalytic explanation of psychosomatic illness, organ language is the bodily expression of an unconscious conflict as a form of symbolic communication. It is also called organ-speech, a term that Sigmund Freud uses in his 1915 ...

Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...

's famous case study of

Anna O. Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (''). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...

featured a woman who suffered from numerous physical symptoms, which Freud believed were the result of repressed grief over her father's illness, although treatment did not resolve her symptoms and later research is skeptical of Freud's diagnosis.

Children

While it is normal for stresses and strains in a child's life to be expressed in bodily pains/upsets, there is evidence that children in families where bodily complaints receive special attention are significantly more likely to use somatization as a defence in later life.

Treatment

Treatment for somatic symptom disorders combine different strategies for managing the patient's symptoms, including regularly scheduled outpatient visits, psychosocial interventions (such as joint meetings with family members), psychoeducation, and treatment of prominent comorbid symptoms of anxiety or depression. Based on multiple systematic reviews, the initial suggested treatment for somatic disorder is regular, scheduled outpatient visits (every 4–8 weeks) that are not based on active symptoms. These visits should focus on establishing a therapeutic alliance, legitimizing the somatic symptoms, and limiting diagnostic tests and referral to specialists.

Cultural examples

Author

Virginia Woolf Adeline Virginia Woolf (; ; 25 January 1882 28 March 1941) was an English writer, considered one of the most important modernist 20th-century authors and a pioneer in the use of stream of consciousness as a narrative device. Woolf was born i ...

's mental and emotional difficulties were often expressed directly in physical symptoms: "Such 'sensations' spread over my spine & head...the horror – physically like a painful wave about the heart".Quoted in Hermione Lee, ''Virginia Woolf'' (1996) p. 187

References

External links

Pain and Somatization
{{Defence mechanisms Somatic symptom disorders Defence mechanisms