You’re flabbergasted. The lab and imaging results came back normal, which means there’s no medical explanation. “There has to be a mistake. My headaches and nausea are real!” No doubt they are, but are you willing to consider the otherworldly relationship between mind and body? Let’s chat about somatization…
When it comes to therapy for somatization, the focus is upon alleviating distress, not proving the person wrong about the cause of their misery.
When medical explanations aren’t to be had, taking a long, hard look at the impact of our stressors makes good sense. And when we do that, we’ve crossed the somatization threshold.
What is somatization?
In the psych world, somatization is the conversion of mental experiences or states into bodily symptoms. “Soma”: from the Greek for body.
Yes, the headaches and nausea of our friend in the intro are real, even though she has no medical explanations. When she gets over the shock, she may connect some dots that take her to her recent divorce. And maybe she’ll consider the possibility that she’s somaticizing her anger and grief through her physical ailments.
Keep in mind, somatization is a symptom, not a disorder.

“Okay, it’s real, but I’m good physically. All I need to do is keep working on my anxiety.”
It’s crucial to understand that somatization isn’t about faking or imagining. And it isn’t pretending to be ill for purposes of personal gain (malingering). The symptoms are real as can be.
Now, most of us have had episodes of somatization. However, treatment isn’t indicated unless they’re causing severe and chronic distress.
Here are some of the diagnoses listed under the DSM-5 category, Somatic Symptom and Related Disorders: somatic symptom disorder, illness anxiety disorder, conversion disorder, factitious disorder.
What causes somatization?
It frustrates me when I write about the cause of an emotional/mental concern because I have to point-out that rock-solid cause is tough to come by. And that means we’re left with theory, contributors, and triggers. That brain of ours.
Somatization, then…
- Biological sensitivity: There could be a heightened sensitivity to physical sensations such as pain or nausea. That being the case, an individual may connect the sensations to being ill. Someone may misinterpret psychological symptoms, such as anxiety-driven breathing problems, as having a physical cause.
- Trauma/Stress: According to research, survivors of trauma are particularly susceptible to somatization. Trauma can result in high cortisol levels, as well as other hormones. They can weaken the immune system, causing a variety of unpleasant symptoms.
- Unconscious Mind: Somatization may be a defense mechanism, protecting us from being emotionally overwhelmed. In the presence of over-the-top emotional/mental distress, an individual may believe they can’t deal with it consciously. In converting the distress to a physical symptom, the body becomes the outlet.
- Cultural attitudes: Some cultures stigmatize emotional distress. It makes sense that an individual may garner more attention and sympathy if they present physical symptoms. Hence, an individual’s mind and body may learn to somaticize distress to secure help.
How is somatization treated?
Treatment for somatization becomes a possibility when the struggling individual is willing to believe they’re experiencing it. Often, that doesn’t come easy. For instance, if the individual’s doc suggests somatization is at play, and provides a therapy referral, they may feel that their physical issues are being dismissed. They may even see multiple physicians in an effort to acquire a medical explanation.
When it comes to therapy for somatization, the focus is upon alleviating distress, not proving the person wrong about the cause of their misery. The idea is, if the individual’s depression, anxiety, or trauma-driven distress is generating somatization, relieving said distress will ameliorate it.
But there’s more to the essentials of somatization therapy, including a strong therapeutic relationship. The individual is likely overwhelmed by their symptoms. That may lead them to worry that their therapist thinks they’re faking. So, it’s important that the individual feels safe when discussing their fears, feelings, memories – anything having to do with their somatization.
Cognitive behavioral therapy (CBT) is highly effective in treating somatization. That’s because it helps the individual identify their automatic negative thoughts and confront them with less self-defeating input. Again, the idea is if distress is reduced, so is somatization.
There are other therapies that may be indicated based upon the cause of the somatization. For example, someone with trauma-generated somatization may benefit from, say, eye movement desensitization and reprocessing (EMDR). Somatization caused by relationship or family stress may respond well to couples or family therapy.
Earlier we reviewed some of the diagnoses listed under the DSM-5 category, Somatic Symptom and Related Disorders. You can bet each of them has specific therapy strategies and techniques.
Finally, perhaps someone struggling with somatization is a family member or friend. If you’d like to become involved, and the individual is willing, try to get them to talk about their underlying feelings. The more the individual expresses verbally, the less they’ll express physically. Throughout the relationship, make it your business to maintain a safe environment: no judgment, no arguments – just empathy and support.
Before we close, I want to share that I’ve had my tussles with somatization since I was a kid. My primary malady has always been breathing difficulty. Time has convinced me that it really is a somatization issue. However, one has to keep their edge because sneaky misleading thoughts can present anytime. That’s when I begin whispering to myself, “Somatic, somatic, somatic…” It helps.
You just never know
Somatization: the mind to body conversion. What a shame it can cause so much pain because it really is an otherworldly phenomenon.
You may be wrestling with an ailment that has no medical explanation – maybe it’s someone you love or know. As nonsensical as it may first seem, consider somatization. I mean, you just never know.
I relied heavily upon GoodTherapy for this piece. Thank you for the usual fine information. Check-out their site and learn. You can even find a therapist.
Speaking of finding, how ’bout hundreds of mood and anxiety disorder related articles? All you have to do is review the Chipur titles.