Psychosomatic Symptoms

Understanding Psychosomatic Symptoms & How Therapy Can Help

Research shows that one-third to one-half of all doctor visits are due to psychological factors 1.

For many of these problems that people traditionally visit a doctor for (ranging from migraine headaches, joint pain, back pain, and fatigue to gastrointestinal problems) doctors are often not able to find a physical or structural cause, despite many diagnostic tests.

When this occurs, these symptoms are then referred to as psychosomatic or “medically unexplained” symptoms. Commonly, in this kind of experience, doctors are at a loss with how to help since a solution may be outside of standard medical treatment.

This may seem hard to believe, but before you jump to believing that “it’s all in your head,” think again. It is much more complex than that.

Psychosomatic symptoms are real and cause physical suffering.

Once you’re past the disbelief, the next natural questions are: what creates the symptoms, and how best to treat them? If you have been struggling with nagging medical problems despite your doctor’s best intentions, you may want to have a conversation about mental health treatment.

What Is Psychosomatic Pain In The Body?

Psychosomatic pain can be present in many areas of the body. The location of this pain, how often you experience it, and how long it lasts really depends on individual circumstances and history.

Common examples of psychosomatic pain and problems include:

Other symptoms can fall into the psychosomatic bucket, these are just the most common. What’s important to note is that there isn’t a physical or structural reason for your pain. Once those variables are crossed off, it’s reasonable to explore mental health as being a part of the experience.

What Causes Psychosomatic Pain?

The mind-body connection is more powerful than many people realize. It has a lot to do with how human beings process emotional experiences and anxiety. An emotion is a physical experience in the body in response to something that happens to you. Emotions such as anger, fear/anxiety, joy, love, grief, and guilt all are experienced differently in the body.

Anxiety is a special kind of emotion when it comes to pain in the body

Anxiety is part of your body’s threat detection system and it’s hard-wired in via your central nervous system. Anxiety is a signal to the body (and to you) that a threat of some kind is present.

While you can experience fear in response to an actual physical threat, for example, being near an aggressive dog, you can also experience fear due to what is going on inside of you without an immediate threat. This kind of anxiety is often due to an emotional memory from your past being triggered in the present moment. Memories like this can be triggered by anything from current events, a relationship, something you watch on TV, or even listening to others share their experiences.

Anxiety can translate to pain in the body in surprising ways. From headaches to stomachaches, back pain, dizziness, restlessness, difficulty sleeping, heart palpitations and more.

How Do I Know If My Pain Is Psychosomatic?

You won’t really know until you go to your doctor to get a full examination to rule out any physical or structural causes of your symptoms. Self-diagnosis through Internet research is not advisable. Your doctor may refer you to different specialists, such as a neurologist or GI specialist, after ruling out all the obvious choices.

After ruling out all structural possibilities, a referral mental health professional who specializes in the diagnosis and treatment of psychosomatic symptoms may be in order.

Here Is How I Can Help You With Psychosomatic Conditions

Often when patients are educated by their doctor that their condition is due to psychological stress, and that it is reversible, the fear and worry about their symptoms begin to lessen. This knowledge alone can lead to further relief deactivating the fight/flight alarm system.

That said, and as a general rule, your symptoms will be triggered when you experience psychological stress and will subside when you are more relaxed and less stressed. Consider how your symptoms are at work vs. vacation? Being aware of how your body responds to stress is important and helpful and definitely something to share with your doctor or mental health professional.

How ISTDP Can Help

  • Due to the fact that psychosomatic conditions are due to conditioned emotional responses from past experiences, treatment often requires the psychotherapist to work at a deeper emotional level to help the individual release “unfinished” emotions caused by attachment trauma. ISTDP, as an attachment-based mind-body therapy, has been shown to be uniquely effective in treating these conditions.
  • Cognitive Behavioral Therapy (CBT), another popular and effective treatment, emphasizes working at the thought and behavioral level. For this reason, the treatment often does not provide enough emotional work to get to the root of deeper emotional trauma 2.

How I Have Worked With Psychosomatic Symptoms In ISTDP Therapy In The Past

I once worked with a woman in her 50s who had a lifelong struggle with depression, suicidal ideation, and a host of health problems including back and joint pain, tension headaches, and gastrointestinal problems. She was diagnosed with Irritable Bowel Syndrome by her doctors, and the medical cause was never determined.

She also shared that she had a trauma history which included repeated sexual abuse before the age of 9 and an early home environment characterized by physical and emotional neglect.

She had been on medications for most of her adult life and had been to many therapists with little relief. She came to me hopeful that something could be done to finally get the help she needed. Although she stated that previous mental health treatment was helpful due to the opportunity to talk to people who cared, she also noted that she continued to struggle in a significant way with depression, low self-esteem, self-sabotage, and health problems.

At the time of seeing me, she did not realize that her health issues could be so strongly related to her trauma history. While working together in therapy, I challenged her in ways to face, rather than avoid, difficult emotions that other therapists never had, and helped her see more clearly her own self-defeating behaviors and turn against them.

In one session, with high emotional activation due to the rage she felt toward an uncle who sexually molested her, the muscle spasms and tension in her lower back were released. She was amazed at this and saw an immediate link to emotional release.

These self-defeating behaviors are often what perpetuate our mental health and health problems. Over time, she saw a remission in depression as well, no longer experiencing IBS and back pain.

In the process, she was able to let go of the idea that she was responsible for what happened to her and began to take a healthy responsibility for herself. She was able to grieve the life she had lived, the life that never was, and make peace with herself.

Her story may not be your story, but this is how ISTDP therapy with me works to help relieve your complex psychosomatic symptoms when the two are related.

Psychosomatic Symptoms: Frequently Asked Questions

It is important to note that you experience real pain in both. Some people misunderstand psychological pain as fake or not real, or “all in your head”. The question is what is at the root cause of the pain, a physical/structural problem in the body or conditioned neural pathways? The pain itself can feel the same, regardless of the cause.

Pain killers (also called Analgesics) are a large umbrella of medications used in the management and treatment of pain. These include several classes of medications such as acetaminophen, nonsteroidal anti-inflammatory drugs (eg. Ibuprofen), antidepressants, anticonvulsants, local anesthetics, and opioids. Each class of drug operates differently in how pain is treated in the body. It also depends on the kind of psychosomatic problems and/or symptoms that are experienced. When most people think of painkillers they think of opioids. Yes, opioids certainly work to treat pain having its roots in emotional and psychological processes, as well as most other classes of painkillers.

Yes, psychosomatic pain is curable and can fully be treated by psychotherapy.

Get In Touch With Me

If you’re ready for this kind of support, I would welcome the opportunity to work with you. My services are cash-based and I am accepting clients now.

My office is in Annapolis, MD and you can reach me for a consultation by calling (410) 562-9647 or sending me an email at

If this is a true emergency, please call 911 or go to your local emergency room for support.