Somatization is the generation of
somatic
Somatic may refer to:
* Somatic (biology), referring to the cells of the body in contrast to the germ line cells
** Somatic cell, a non-gametic cell in a multicellular organism
* Somatic nervous system, the portion of the vertebrate nervous syst ...
symptoms due to
psychological distress
Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, ...
, often coinciding with a tendency to seek medical help for them. The term ''somatization'' was introduced by
Wilhelm Stekel
Wilhelm Stekel (; 18 March 1868 – 25 June 1940) was an Austrian physician and psychologist, who became one of Sigmund Freud's earliest followers, and was once described as "Freud's most distinguished pupil". According to Ernest Jones, "Stekel ...
in 1924.
Somatization is a worldwide phenomenon, with chronic cases being classified as
somatic symptom disorder
Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symp ...
.
Associated conditions
Somatization can be, but is not always, related to certain
psychiatric conditions such as:
*
Mood disorders
A mood disorder, also known as an affective disorder, is any of a group of conditions of mental and behavioral disorder where the main underlying characteristic is a disturbance in the person's mood. The classification is in the ''Diagnostic ...
(e.g.,
major depressive disorder
Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive depression (mood), low mood, low self-esteem, and anhedonia, loss of interest or pleasure in normally ...
)
*
Anxiety disorders
Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause phys ...
*
Somatic symptom disorder
Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symp ...
The
American Psychiatric Association
The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 39,200 members who are in ...
(APA) has classified
somatoform disorders
Somatic symptom disorder, also known as somatoform disorder or somatization disorder, is chronic somatization. One or more chronic physical symptoms coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those sympt ...
in the
DSM-IV
The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
and the
World Health Organization
The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
(WHO) have classified these in the
ICD-10
ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social cir ...
. Both classification systems use similar criteria. Most current practitioners will use one over the other, though in cases of borderline diagnoses, both systems may be referred to.
Theory
Ego defense
In
psychodynamic theory
Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
, somatization is conceptualized as an
ego defense, the unconscious rechannelling of
repressed emotions into somatic symptoms as a form of symbolic communication (
organ language).
Sigmund Freud
Sigmund Freud ( ; ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies seen as originating fro ...
's case study of
Anna O.
Bertha Pappenheim (27 February 1859 – 28 May 1936) was an Austrian-Jewish feminist, a social pioneer, and the founder of the Jewish Women's Association (). Under the pseudonym Anna O., she was also one of Josef Breuer's best-documented pat ...
featured a woman who suffered from numerous physical symptoms, which Freud believed were the result of repressed grief over her father's illness, although his assessment has been questioned by later research as treatment did not resolve her symptoms.
Treatment
Treatment for somatic symptom disorder typically combines different strategies for managing the patient's symptoms including regularly scheduled outpatient visits, psychosocial
interventions (e.g., joint meetings with family members),
psychoeducation
Psychoeducation (a portmanteau of psychological education) is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness. Psychoeducation is most of ...
, and treatment of prominent
comorbid
In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sicknes ...
symptoms of
anxiety
Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
or
depression.
Based on multiple systematic reviews, the initial suggested treatment for somatic symptom disorder is regular, scheduled outpatient visits every 4–8 weeks that are not based on active symptoms. These visits often focus on establishing a therapeutic alliance, legitimizing the somatic symptoms, and limiting diagnostic tests and referral to specialists.
See also
*
Psychosomatic medicine
Psychosomatic medicine is an interdisciplinary medical field exploring the relationships among social, psychological, behavioral factors on bodily processes and quality of life in humans and animals.
The academic forebearer of the modern field o ...
*
Identified patient
Identified patient (IP) is a clinical term often used in family therapy discussion. It describes one family member in a dysfunctional family who is used as an expression of the family's authentic inner conflicts. As a family system is dynamic, th ...
*
Somatosensory amplification
*
Hypochondriasis
Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that th ...
*
Medically unexplained physical symptoms
Medically unexplained physical symptoms (MUPS or MUS) are symptoms for which a treating physician or other healthcare providers have found no medical cause, or whose cause remains contested. In its strictest sense, the term simply means that the ca ...
*
Nocebo
A nocebo effect is said to occur when a patient's expectations for a treatment cause the treatment to have a worse effect than it otherwise would have. For example, when a patient anticipates a side effect of a medication, they can experience that ...
*
Somatic marker hypothesis
The somatic marker hypothesis, formulated by Antonio Damasio and associated researchers, proposes that emotional processes guide (or bias) behavior, particularly decision-making. '' Descartes' Error''
"Somatic markers" are feelings in the body t ...
References
External links
Pain and Somatization
{{Defence mechanisms
Somatic symptom disorders
Defence mechanisms
1920s neologisms