“It’s not all in your head!” Reducing the stigma and clear up misunderstandings about psychosomatic illness

BY SIMONE J. SMITH

You have not been feeling well, and you have genuine physical symptoms: pain, fatigue, and even gastrointestinal issues. You become preoccupied with these symptoms and worry about their cause and implications. You feel overwhelmed by stress, anxiety, and a range of other emotions, which contribute and have exacerbated your physical symptoms.

You have been dealing with this unexplained, or chronic physical symptoms and it has been frustrating and confusing. You have gone to doctors, received second opinions, and you find it challenging to understand why you are experiencing these symptoms, especially when medical tests do not reveal a clear physical cause. Now, you feel the need to prove the legitimacy of your symptoms and struggle with the perception that their condition is not “real.”

What you are experiencing is a psychosomatic episode. It is an experience where you have physical symptoms that are influenced, or caused by psychological factors, such as: stress, anxiety, or emotional distress. It’s important to note that psychosomatic symptoms are real and can have a significant impact on your well-being. I also want to note here that the thoughts of a psychosomatic individual can vary widely depending on the specific circumstances.

Medicine has a long and ignominious history with conditions for which they cannot find a physical cause, often dismissing them with sexist terms such as “hysteria.” It is this dismissal that has fostered a fundamental misunderstanding of how these very real illnesses manifest.

Since psychosomatic symptoms mimic physical illnesses, individuals may fear that there is an underlying serious medical condition. This fear can contribute to heightened anxiety and stress, creating a cycle where emotional distress exacerbates physical symptoms.

While many people with these conditions are told “It’s all in your head,” or dismissed as hypochondriacs, Suzanne O’Sullivan (a consultant Neurologist at the National Hospital for Neurology and Neurosurgery), and the author of “The Sleeping Beauties: And Other Stories of Mystery Illness” (Pantheon, 2021), is doing the research to let people know that it is not all in your head.

As part of her work, O’Sullivan aims to reduce the stigma and clear up misunderstandings about psychosomatic illness.

“A lot of doctors still have lingering doubts that if you’ve got a pain due to a disease and a pain due to psychosomatic problems, the doctors still have a bit of a problem understanding that both these pains can be equally painful.

So, I think it’s not an awareness problem; it’s a problem with a lot of old-fashioned hang-ups. They think it’s not as severe as [other] diseases, they don’t take it as seriously as [other] diseases. I think that’s more of a problem rather than a lack of awareness. So, they alienate patients by backing away from the diagnosis.”

She goes on to explain the importance of her research, and the ability it will have when working with individuals who suffer with psychosomatic episodes.

“I think that’s an enormously useful bit of research because of the difficulty with patients — you can imagine if you were paralyzed and someone says, ‘This is psychosomatic.’ The thing that will most help you move forward is if the doctor can say to you, ‘These are the brain mechanisms that are causing your paralysis.’ A real stumbling block for people is like, ‘How could stress possibly cause this?’

So, a big focus for research now is mechanisms to help people understand what’s happening to their bodies. I would say that where we are really still making almost no progress is actually on treatment. We’re still kind of using short courses of talking therapies and things that aren’t terribly successful for these things.”

It’s important for individuals experiencing psychosomatic symptoms to seek professional help and discuss with a trusted physician a comprehensive approach that addresses both the psychological and physical aspects of your condition. Psychotherapy, stress management techniques, and sometimes medication can be part of an effective treatment plan for psychosomatic disorders.