Somatisation: what is it and how to avoid it?

The human being is very complex. Historically, however, psychological approaches have proposed a separation between body and mind that does not conform to psychological reality.

This simplification derives from the idea that physical problems, symptoms or disorders always have a biological origin. However, the reality is that people can suffer entirely physical signs, such as a chronic headache, due to an emotional problem or difficulty. This condition or disorder is commonly referred to as somatisation.

What is somatisation?

From a psychological point of view, Somatisation disorder is a form of defence against emotional anxiety. The person has an emotional conflict that generates great fear but displaces it into the suffering of physical symptoms.

Historically it was called Briquet's Syndrome, and its prevalence is 2%, i.e. it is suffered by a relatively large percentage of the population, two out of every hundred people!

It usually starts in adolescence, and people who have it could describe symptoms more dramatically than usual, with a lot of anxiety, and complain that doctors can't find what they have. Also, women are more likely to suffer from it than men.

You should bear in mind that it is not conscious, i.e. the decision is not made to suffer psychosomatic pain or to feel nausea, but the person's body reacts in this way without realising it. So it must be clear that this is not a pretense. The person is suffering from it.

Usually, when a person comes to the doctor suffering from continuous pain, but no physical explanation can be found, the doctor considers the possibility that they have started to somatise.

Common sensations in somatisation

For most people, symptoms of anxiety are diagnosed as such. People who experience anxiety in this way interpret these sensations differently. An example will help us to understand this better:

Throughout the day, and in a standard and physiological way, physical symptoms of all kinds are perceived, for example:

  • Bowel movements.
  • Tinnitus or tinnitus.
  • Changes in heart rate.
  • Shortness of breath during physical exertion.
  • Feeling of excessively moist or dry skin.

Usually, these mean nothing to people and are typically overlooked sensations. However, people who tend to somatisation look at these sensations and try to explain them. This way of experiencing bodily sensations is called somatic fixation.

Suppose this happens in very stressful situations, such as the death of a loved one or a severe problem such as losing a job or similar. In that case, it is not a somatisation disorder but something transitory. Read more about the relationship between somatisation and stress here.

But if, on the other hand, this becomes the habitual way of responding to any problem or becomes chronic from a given moment onwards, it may have this clinical significance.

This is very important because most of us have somatised at some time. It is common in bereavement processes. A diagnosis of this type cannot be made unless it is chronic, habitual, persistent and affects social and personal life significantly.

Those suffering from depression tend to somatise pretty frequently. It is estimated that between 63% and 94% of people with depression have had such symptoms at some point.

Common symptoms

Some of the symptoms are as follows:

  • Widespread pain: headaches, abdominal pain, back pain, joint pain, chest pain, etc. Severe pain may also occur during menstruation, sexual intercourse, or urinating.
  • Gastrointestinal problems: nausea, bloating or vomiting, for example. Diarrhoea or difficulty digesting certain foods is also common.
  • Sexual symptoms: disinterest or lack of sexual desire, erectile and ejaculatory dysfunction in men, excessive bleeding or menstrual disturbances in women.
  • Occasionally neurological symptoms appear, such as difficulty swallowing, feeling a lump in the throat, hoarseness, deafness, blindness, amnesia, urinary retention or loss of sensation in the skin.
  • When explored and tested, nothing fits, i.e. we cannot explain it by a physical or medical illness. But neither can it be explained by the person's use of drugs, alcohol or medication.

How to prevent and treat somatisation

When a person is diagnosed with somatisation, medication to relieve physical symptoms can be combined with psychological treatment, usually cognitive behavioural therapy.

Therapy that improves the patient's understanding of what is happening to them can help. In this way, the person gradually realises that it is the difficulties in their life, both at work or school and on a personal level, that they are finding it difficult to cope with or generate conflict.

The problem is that often, because the physical symptoms are so real, these people refuse psychological treatment. If the person rejects that, in their case, their symptoms are of psychological origin, it is essential to start by explaining to them what somatisation is.

What can you do?

Ideally, the family doctor who usually sees this person should help them understand what is happening. However, if they are referred to a psychologist or psychiatrist, it is important to explain that it is somatisation does not mean that they are inventing anything. They are real symptoms, but you can learn to manage them so that they do not prevent you from living better.

How to do this

If you think you may be suffering from these symptoms, it is essential to learn how to manage your anxiety:

  • Learning to manage the conflicts of everyday life, with a person to guide you and help you deal with them appropriately. In this sense, therapy is essential for making progress in your daily life.
  • If your doctor recommends an anxiolytic or antidepressant, this can help. But therapy is necessary for the long term, as you need to change the way you behave in the face of emotional conflicts. Nevertheless, with support and persistence, a great improvement can be achieved.


The starting point is to assess the symptoms, and once these are known in detail, the therapy goals are set. After a detailed explanation to the patient of what is happening and why, work will be done to modify thoughts and behaviours. Dysfunctional beliefs do not have a specific function and produce more discomfort for those who suffer from them. Therefore, working on these thought patterns is essential to make the person feel better.

Therapy will also boost the person's self-esteem, teaching them to accept their achievements, values, abilities and positive virtues and recognise them.

Tips for somatisation

1. Identify that something is happening

It is crucial to "realise" that there is an emotional problem. So, for example, when you suffer from physical pain or discomfort, and there is no organic cause for it, think if there is a problem affecting you.

2. Don't avoid the problem

You should verbalise what is happening to you and call everything by its name without facing it. For example, if you can't stand a job that exceeds your psychological strength, it is imperative to express it and tell yourself and the people around you.

3. Ask for help

If necessary, see a therapist. Acknowledging what is happening to you makes you feel better, and you can emotionally unload part of the problem. It is therapy with a professional that will provide you with the necessary strategies to handle better and teach you how to manage emotional conflicts effectively.

4. Change the way you think

It is necessary to learn to think healthily. This is sometimes the main reason for going to therapy. It is not to cure you of an illness but to learn to think differently. For example, living with fear, resentment, sadness, or anxiety can lead to psychosomatic illnesses. So don't miss the opportunity to learn to think more positively. And one of the keys is: you control your emotions. Emotions should not prevent you.

If necessary, you should avoid those situations that make you feel so much emotional discomfort. For example, we know that it is not easy to leave a job or a personal relationship; however, sometimes you have to decide to get better. Chronic stress is worse for your body.

5. Watch your routine and be open to others.

Review your lifestyle and change your habits. Seek healthy support from friends or even start doing activities that involve helping others. Feeling support from others is extremely important.

You also need to be patient with yourself and permit yourself to let off steam. Crying, sharing your fears and emotions is necessary and highly recommended. Read more about the effectiveness of relaxation in stressful situations here.

6. Positive attitude

The change of mentality is fundamental. Even if an actual physical illness caused it, a positive attitude changes that illness completely. It has been proven that a positive attitude improves heart rate, improves the body's defences, causes us to generate endorphins that will enhance our physical well-being and improve our self-esteem.

In reality, by changing the way you deal with problems, you can improve your physical symptoms considerably. And, above all, you must understand that somatisation is not a character flaw. It has happened to all of us at some point in our lives, but you can do something about it. So follow these tips, go to psychological therapy, improve your life habits, detect the things, people or situations that make you feel bad and try to change what makes you feel this way. You can do it!

At therapyside, you will find professionals who can advise, support and help you achieve your best version.

[.test-button]Find your therapist[.test-button]