Somatization occurs when psychological concerns are converted into physical symptoms. Though they have no underlying physical cause, somatic symptoms, such as pain or nausea, are very real and have not been invented by the person experiencing them.
Sometimes psychological symptoms can be so distressing that a person cannot face them. When psychological symptoms become overwhelming, some people tend to interpret the symptoms as physical illnesses. The physical illness is not fake; instead, the psychological distress has been converted to a physical symptom.
Most people experience somatization at some point in their lives. Throwing up from anxiety, having a headache due to stress, feeling shaky because of grief, or getting sick after a trauma are all examples of somatization. However, people who regularly convert psychological symptoms into physical ones may be diagnosed with a somatoform disorder such as body dysmorphic disorder, pain disorder, or conversion disorder.
Somatoform disorders are controversial because many legitimate physical conditions, including fibromyalgia, have been previously thought to be somatoform disorders. Some theorists argue that women and minorities are more likely to be diagnosed with somatoform disorders because their health problems are not taken as seriously. Indeed, many of the somatoform disorders contain symptoms previously associated with hysteria—a diagnosis primarily given to women.
Somatization is distinct from faking an illness to get attention or claiming to have a headache when the real problem is stress. To the person experiencing somatization, the symptoms are real. Somatization is presumed to be caused by psychological distress that the patient is unable to face, and some people, for example, may interpret psychological distress as pain. An anxious person might feel a pit in his or her stomach and begin to focus on the pain, interpreting the physical anxiety as a physical illness. Survivors of trauma are particularly susceptible to somatization, and physical symptoms may co-occur with other mental health conditions such as depression or bipolar.
Stress can also weaken the immune system, and the release of cortisol and other stress-related hormones can cause physical symptoms. Although it might seem that mental and physical health are completely different, there is not such a clear distinction between the mind and the body, and many psychological states have physical symptoms; in some people, these states may be ignored and the physical symptoms may become more distressing.
Somatoform disorders are a group of conditions that cause physical symptoms without an underlying physical cause. Somatoform disorders are differentiated from factitious disorders because people with somatoform disorders are not consciously faking their symptoms; rather, psychiatric states cause physical distress.
The Diagnostic and Statistical Manual (DSM) recognizes the following somatoform disorders:
- Conversion disorder: The loss of bodily functioning such as sight or hearing due to psychological distress
- Pain disorder: Chronic pain with no underlying physical cause
- Body dysmorphic disorder: A persistent distorted body image
- Undifferentiated somatoform disorder: One physical symptom that has no physical cause and lasts for more than six months
- Hypochondriasis: Constant worry about developing an illness, often accompanied by the belief that one already has the illness
- Somatization disorder: A collection of unexplained—and often unrelated—physical complaints with no physical cause
Many people who experience somatization first seek the help of a medical doctor due to the unwanted physical symptoms they are experiencing. If a medical doctor rules out any underlying physical cause of a person's physical symptoms, they may refer the person to a trained mental health clinician. A therapist or counselor can better address and treat the underlying psychological issues, and thus minimize or alleviate distressing physical symptoms. Clinicians frequently attempt to help patients develop coping skills to enable them to deal with both physical and psychological pain.
- American Psychological Association. APA concise dictionary of psychology. Washington, DC: American Psychological Association, 2009.
- Somatization disorder. (n.d.). Mental Disorders. Retrieved from http://www.minddisorders.com/Py-Z/Somatization-disorder.html
- Somatization disorder. (n.d.). U.S National Library of Medicine. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000955.htm