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Are psychosomatic illnesses ‘real’?

Although they can be manifestations of psychological stress, the pain and discomfort of a psychosomatic disorder should be treated both in the mind and the body

Headaches are among the most common manifestations of a psychosomatic illness
Headaches are among the most common manifestations of a psychosomatic illness (Andrea Piacquadio/Pexels)

Every month, 10% of incoming patients at the All India Institute of Medical Sciences (AIIMS) in New Delhi suffer from psychosomatic disorders. While 10% may not sound like too much, the long term consequences for such conditions are detrimental and need to be understood by paying attention to the connection between one’s body and mind. Mumbai-based clinical psychologist Dr. Rochelle Suri (PhD, MFT) breaks down psychosomatic disorders for a lay person by providing an example of what so many of us experience but do not understand, before delving into the details of what needs to be done.

Tanya, a 22-year-old college graduate, had been suffering from severe abdominal discomfort and spasms, since the last 10 years. Having gone through every medical and alternative treatment, such as an endoscopy, colonoscopy, Ayurveda, Acupuncture, traditional healing, including working with medical diagnoses of Irritable Bowel Syndrome and Endometriosis,

Tanya struggled with intermittent abdominal pain and bloating, several times a month.

Medically, Tanya was all in the clear and there was no legitimate explanation for her pain which would increase with time. Having given up all hope on ever feeling better, she decided to give psychotherapy a try; her doctor had suggested the possibility of a connection between her physical discomfort and psychological stress.

Through her sessions, Tanya uncovered trauma in her childhood, particularly to do with her abusive relationship with her father. Using a combination of talk therapy and somatic psychology, Tanya discovered she was sexually abused as a child. Unfortunately, she unearthed disturbing memories of her father, which she had repressed, a coping mechanism most people use, as a way to deal with and navigate the emotional pain. It was when she was able to understand, accept and resolve these memories, through intensive therapy sessions, that Tanya no longer struggled with the abdominal pain.

The above example is reflective of a psychological condition broadly referred to as psychosomatic illnesses. While anxiety, clinical depression, mood disorders and other psychotic disorders are commonly diagnosed, psychosomatic disorders generally go overlooked. According to Reber, Allen and Reber (2009), “Psychosomatic Disorders is a general label used for any disorder with somatic (bodily) manifestations that are assumed to have at least a partial cognitive and emotional aetiology, i.e. that are to some degree psychological or related to mental and emotional stress.”

In most people, psychosomatic disorders manifest as recurrent headaches, heart palpitations, excessive sweating, physiological pain, various skin diseases, gastrointestinal disturbances and nausea. A psychosomatic illness can also manifest in several sexual dysfunctions, which include, but are not limited to, amenorrhea, debilitating menstrual cramps, erectile dysfunction, etc. Psychosomatic illnesses are not considered life threatening conditions, but chronic symptoms can lead to major depression or suicidal thoughts.

While there are no exact causes for psychosomatic disorders, some theories have been established, which strongly suggest a correlation between psychological stress and physiological medical conditions. One theory states that an individual’s overall personality (say, someone who suffers from anxiety) can cause a psychosomatic disorder. Another theory links an individual’s lifestyle (for instance, people who have high pressure jobs) to the disorder. Yet another theory suggests that psychosomatic disorders can manifest due to a heightened reaction to substances (eg: allergies that can be stimulated by foreign substances, but experienced or manifested differently, depending on psychological factors). Finally, it is also believed that psychosomatic illnesses have a genetic component. Psychosomatic disorders present differently in genders and other populations. For instance, women often report abdominal bloating, fatigue and irritability, while men often experience muscular pain, hypertension and change in their sex drive.

On a final note, a common misnomer is that psychosomatic conditions are imaginary or created to use as an excuse to avoid personal tasks and responsibilities. Physical symptoms of psychosomatic conditions are real and should be approached with seriousness and concern; they require treatment just as any other illness would. Hence, it is critical that one seek psychological assistance or psychotherapy to address such concerns, after first ruling out any organic or medical causes for the symptoms.

This article was originally published on AaraHealth.co, a health-tech company focused on creating science-backed healthcare products and content for women in India. It has been lightly edited for style.

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