What Do You Mean, It’s All In My Head? – Understanding Psychosomatic Symptoms

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I am always saddened when I hear stories of people being told that a symptom or experience is “all in your head.” Often, these words come from a well-meaning people, perhaps a doctor or a concerned spouse, but these words can wound those that hear them.

People can feel that their concerns are being dismissed or that their sanity is being questioned. “It’s all in your head” can easily be received as “what you’re feeling isn’t real” or “you must be faking.” These are damaging messages, because they do not account for the subjective reality of the person experiencing the symptom.

This type of message is communicated all to often to individuals who are experiencing psychosomatic, or mind-body symptoms. Apart from their emotional toll, these messages can stand in the way of people getting the help that they need. A patient may start shopping for a new doctor instead of addressing the underlying roots of a problem.

So what exactly is a psychosomatic symptom?

Psychosomatic symptoms (sometimes referred as psychogenic symptoms) are bodily symptoms have their origins in the mind (either wholly or in-part). Examples can include tension headaches, digestive issues, chronic pain, and a whole host of other concerns.

Generally, psychosomatic symptoms are viewed as being distinct from symptoms that have a “physical basis,” such as pain from a broken bone. However, this sort of dichotomous (black or white) thinking can be problematic, as many conditions can have both physical and mental/emotional components.

It is often more helpful to consider psychosomatic symptoms as existing on a mind-body continuum. One way of determining if a condition has a psychosomatic component is to consider whether the symptoms are made worse by emotional conflicts, tension, or stress. Unfortunately, this can be hard to see and reflect on when you are in the midst of an experience that might seem entirely physical.

The Role of Stigma

Part of the problem that we face when we consider psychosomatic symptoms is that we live in a culture that has deeply ingrained, negative views about problems that are in any way connected to a person’s mental life. We tend to view mental and physical ailments as completely separate and distinct, and I am sure that I do not need to point out which type of ailment is more socially acceptable.

When individuals in our culture experience a symptom in their body, they do not generally consider how their thoughts or emotions could be contributing to or giving rise to the symptom. Part of this is a lack of education and understanding around the mind-body connection. Another factor is a cultural reluctance to accept the possibility that any of our problems could be mental or emotional.

Even the word emotional sheds some light on this problem. This word carries a whole host of negative connotations. Being emotional might mean that you are unstable, erratic, or out of control. If those are the connotations of being emotional, it’s no wonder that people are reluctant to acknowledge emotional problems.

It makes me wonder why there couldn’t be a shift, in which the term emotional could begin to be used to describe someone who is connected to their feelings. Or perhaps someone who can tolerate a full range of emotional experiences.

HINT: The qualities that I just mentioned are a good thing…Yes, it turns out that these qualities are even good for men to have…

So What Can You Do?

  • Rule out a clear physical cause – It is always important to see a physician to rule out the possibility of a physical cause that can be treated by traditional means. However, I would also encourage people to be open to the idea that psychological factors could be exacerbating physical conditions.
  • Get in touch with your emotions – An important early step of helping psychosomatic symptoms is to get in touch with and acknowledge what you are feeling. Unacknowledged feelings and emotional conflicts are fuel for psychosomatic problems. It is not necessarily important to arrive at a solution for an emotional problem that you are having. The goal at this point is to acknowledge that the feelings exist.
  • Look for connections – As you become more aware of your emotions, you can begin to look for possible connections between your feelings and your symptoms. It can be helpful to create a journal where you regularly write out your feelings. Not only will the expression of the feelings be helpful, but it can also help to find potential connections.
  • Challenge negative thinking patterns – While it is counterproductive to try to disavow negative feelings, it can be helpful to challenge negative thinking patterns. For example, if you find yourself thinking of the worst case scenario about your symptoms, or anything else in life, maybe challenge yourself to think about the possibility of more positive outcomes.
  • Talk to a therapist – It can be very helpful to talk to a therapist who is knowledgeable about psychosomatic / mind-body conditions. A therapist can help you get more in touch with your emotions, and they can help you work through emotional conflicts. If you wish, your therapist can also work with your medical providers to take a team approach to your care.