Psychosomatic Illnesses: The Role of the Mind in Physical Illness

Historical periods affect what physical and mental symptoms are expressed in illnesses having psychological causes. Some medical professionals believe that the unconscious mind is the causative agent. But, there are also important cultural factors. Let’s see how this might be so.

Physical Symptoms with Psychological Causes

Physical symptoms having a psychogenic origin are common and the processes that cause them in the mind/body are known as somatization. When there is actual physical disease but the patient’s responses are inappropriate or exaggerated the processes that cause them in the mind/body are said to be somatogenic in origin.

Four categories of physical and mental symptoms can be identified in which the mind/body fashions diseases states:

1) Sensory symptoms (e.g., tiredness, burning skin sensations)

2) Motor symptoms (e.g., paralysis)

3) ANS or autonomic nervous system symptoms (e.g., irritable bowel)

4) Psychogenic pain symptoms (e.g., headache caused by psychological factors)

From 1820 to 1870 the cultural shaping of somatization in individuals began with the diagnosis of spinal irritation in which the physician acted as an agent of culture in diagnosing the patient’s symptoms. For instance, a condition known as “reflex neurosis” could cause any irritated organ to spread its influence to any other part of the body or brain and the physician’s diagnosis culturally shaped the incidence and popularity of this diagnosis. As women were considered the more passive gender at the time, they were considered more susceptible.

However, two new models of physical illness arose after 1870. One stressed covert but actual disease in the central nervous system (CNS). Neurasthenia or “tired nerves” is a good example:

“…the CNS becomes dephosphorized, or perhaps loses somewhat of its solid constituents; probably also undergoes slight, undetectable, morbid changes in its chemical structure and as a consequence becomes more or less impoverished in the quantity and quality of its nervous force.”

Another stressed the psychological basis of somatization. In this case, the mind creates actual physical symptoms but the patient accepts them as signs of real physical disease, such as the experience of pain:

“From the cultural pool, pain is selected from the symptom pool. But, how people experience pain, how they describe it to others, and how and where they seek help is another thing.”

Currently, in the United States, one of the most common forms of somatization is chronic pain syndrome or fibromyalgia. Its origins have been variously attributed to chronic neurosis, infectious mononucleosis, Epstein-Barr virus, muscle weakness or neuromyasthenia, benign myalgic encephalomyelitis, as well as yeast infections.

The attribution of an illness involves two phases. In the first phase, the patient appropriates a real physical disease as a “template” whose actual cause is difficult to substantiate. In the second phase, the patient broadcasts this “template” to others as an explanation for his or her set of symptoms.

Cultural broadcasting is abetted by numerous factors including solicitous physicians, pharmaceutical companies that stand to make money from selling lucrative prescription drugs and other treatments, patient support groups, and particularly the mass media, which makes money through increased advertising revenue.

The patient draws upon the pool of symptoms from the culture as models of illness to help them understand their “conversations” with their bodies. Indeed, social isolation and loneliness increase somatization and both are correlated with ill health, actual physical disease, frequent visits to physicians, and somatic complaints.

Suggested Reading

Sarno, J. E. (1998). The mindbody prescription: Healing the body, healing the pain. NY: Grand Central Publishing.

Sarno, J. E. (2006). The divided mind: The epidemic of mindbody disorders. NY: HarperCollins.

Shorter, E. (1992). From paralysis to fatigue: A history of psychosomatic illness in the modern era. NY: The Free Press.