Psychosomatic Pain: It’s not all in your head

It’s generally not difficult to identify physical pain. Whether you’ve broken an ankle or just experienced a run of the mill headache, acute pain is an inescapable part of life. Emotional pain is ubiquitous as well, and emotional events in our lives often cause emotional distress, whether it is as routine as everyday social anxiety all the way to mourning the loss of a loved one. But what do we call it if physical pain is caused by an emotional event -- like when your boss yells at you, and all of the sudden you get a splitting headache, chest pain, or a stomach ache?

While we often think of physical pain and emotional pain as separate systems in our bodies, they are indeed very connected, and it is not uncommon that an emotional event will trigger a physical response. When our bodies physically respond to mental unrest, we call this psychosomatic pain.

Stemming from the Greek root words psyche (mind) and soma (body), psychosomatic pain can show up throughout the lifespan and can look different at various stages of our lives. In the early 1900s Freud was well aware that even in infancy the self existed in our bodies, and acted out our emotional dynamics. School-aged children who are not yet able to verbalize their emotional experience frequently visit the school nurse for stomach aches, or even headaches, in response to stress for this same reason. This trend continues through adolescence and older adulthood shifting in how it may look throughout our lifespan.

Why might our bodies respond to emotional pain in this way? One way to conceptualize psychosomatic pain is to imagine your body as a pressure cooker. A functioning pressure cooker ventilates steam at a rate that allows for optimal cooking while not over-pressurizing the cooker. But if no steam is allowed to leave, the cooker will combust and other areas will pay the price. So too for our bodies. If we are not able to put words to our hurt and ventilate our feelings, the emotional pain that needs to be mobilized, becomes pressurized, and is forced to be expressed elsewhere in the body. Early childhood mis-attunements, acute trauma, and other difficult to verbalize stressors are common causes of psychosomatic symptoms and conditions, and can also be difficult to spot.

Common psychosomatic symptoms are far reaching and can affect our entire bodies. They often include fatigue, insomnia, back pain, high blood pressure, labored breathing (dyspnea), indigestion, headaches, migraines, erectile dysfunction, skin rashes, and even stomach ulcers. Other conditions such as Chronic Fatigue, Irritable Bowel Syndrome (IBS) and Tension Myositis Syndrome (TMS) can be caused or intensified psychosomatically. Having any of these symptoms does not mean it is psychosomatically caused, but if otherwise unexplainable could be worth looking into. Oftentimes medical patients are made to feel like their pain is “all in their head” or made up when their doctor cannot find a cause, and increasing research is showing that, in fact, stress hormones are at the cause of psychosomatic pain.

So what do you do when you have unexplainable pain that you think might be psychosomatic in origin? Here are a few steps to begin:

1. Take your pain seriously. Your body is communicating something to you through this pain and is nudging you to listen to it. Past trauma or current stressors are good places to begin investigating.

2. Talk it out. If you have a sense of what you may be holding on to, find a confidant or a therapist and put words to it. Let the pressure cooker ventilate.

3. Get to the root of the pain. When psychosomatic pain is front and center, the root cause of the pain is emotional. While it may be tempting to direct efforts at the physical pain, failure to address the root cause may prolong the discomfort. Learning about what you need to relax to reduce the stress hormones your body is producing can oftentimes reduce the intensity of the pain. Introducing yoga, prioritizing sleep, or even just carving out a little more time to focus on a forgotten hobby may be what you need to start lowering your baseline stress and connecting your body and mind.

By Albert Mezistrano, LICSW