somatization of psychological stress

The somatization of psychological stress is essentially psychological stress that has not been noticed and expressed. The real physical and mental reactions presented through physiological symptoms are by no means "pretending to be sick" or "hypocritical". Current clinical data shows that about 30% of patients in general hospital outpatient clinics have physical discomfort for which no organic cause can be found, and more than 80% of them are related to somatization caused by psychological stress.

I just received a visitor named Xiao Zhou from an operation position in a large factory last month. During the fourth quarter of last year, for three consecutive months despite departmental layoff warnings, it was normal to work overtime until the early morning every day. The first problem was migraine. When the attack occurred, it felt like a helmet filled with lead was pressed on the top of the head, and the temples were throbbing. The pain was so severe that I felt nauseous, and I couldn't even stand looking at a computer screen for ten minutes. He went to the neurology department for a full set of examinations, including brain CT, cerebral angiography, and cervical spine MRI. All indicators were normal. The doctor prescribed some painkillers and asked him to go to the psychology department. He was still not convinced. He felt that his psychological quality was very good. Where could he have any psychological problems. When the pain was so bad that he couldn't go to work, he went for a consultation. He was diagnosed with moderate anxiety with somatization symptoms. He didn't take any specific medicine, so he walked downstairs for 10 minutes every day. With three cognitive adjustments, the frequency of headaches dropped by 80% in about half a month. Now, every time he feels stressed, he stops and writes an emotional diary for five minutes, and the pain is never so bad that he can't go to work.

Regarding the mechanism of somatization, researchers in different fields have never had a unified standard answer, and each has its own perspective. The older generation of psychoanalysts believe that this is because your subconscious mind is helping you hold back unexpressed emotions - for example, you have been taught since childhood that "adults should not lose their temper" and "crying is weak." Those grievances, anger, and anxiety that are suppressed in your heart have no place to go, so they turn around and run into your body to find an outlet. When you have a headache, your head "screams pain" for you. Cognitive behavioral researchers prefer that this is due to your excessive attention to body signals that amplifies the discomfort: when you are stressed, your heart beats fast and your shoulders and neck become tight, which are normal stress reactions. However, you just focus on this discomfort and wonder, "Am I suffering from a serious illness?" Those who engage in neuroscience are more direct, and let the data speak for themselves: under long-term high pressure, the HPA axis (hypothalamus-pituitary-adrenal axis) continues to be excited, and cortisol levels remain high for a long time, which will directly interfere with the normal operation of the immune system, digestive system, and nervous system. To put it bluntly, if you stretch for too long, the body's regulatory switch fails. Of course, some researchers have suggested that the occurrence of somatization is also related to the individual's physiological susceptibility. Not all somatization is entirely a psychological problem. Some people are born with more sensitive autonomic nerves than others, and are more likely to have physiological reactions under the same pressure. Several theories are supported by relevant research data, and there is no absolute right or wrong.

To be honest, I have seen too many people misunderstand somatization too deeply. The most common one is "You are just pretending to avoid responsibility." There was a visitor who was a sophomore in high school. He had diarrhea as soon as he took the mock exam. His parents took him all over the city's gastroenterology department and had gastroscopy and colonoscopy done. No problems were found. When he got home, he scolded the child for "just pretending not to take the exam." Don't think this is a coincidence. Somatization symptoms are real and cannot be controlled by the patient's willpower. Just like you can't rely on willpower to stop a runny nose when you have a cold. Calling him "pretending to be sick" is equivalent to adding another stab to his already painful body.

Oh, by the way, I also tried somatization when I was working on a big project. I had insomnia for a week in a row. My chest felt tight and I couldn't breathe when I sat down. I went to the cardiology department for a full set of tests. The electrocardiogram and myocardial enzymes were all normal. Then on the day the project went online, I just fixed the last bug. After the modification, I stood up and stretched. The tightness in my chest disappeared immediately. I realized at that time that during that time, I was worried every day that I would take the blame if the project failed. I didn’t dare to tell my boss or complain to my colleagues. I carried it all by myself. There was no place for my emotions to go, and they were all stuck in my chest.

There is actually no universal formula for dealing with somatization, and different methods are suitable for different people. If you are willing to explore inwardly, you can try to talk to yourself. Do you have any unspoken emotions recently? For example, you always have a stomachache. Is there something that makes you unable to swallow your breath recently? I once had an administrative client who always had stomach pains. After half a year of investigation, there was no problem. Finally, she told her that her boss always gave her work that was not hers. She was too embarrassed to refuse. Every time she took a job, her stomach hurt. Later, she tried to refuse an unreasonable demand, and her stomach pain was reduced by half that day. She felt it was amazing. It doesn’t matter if you don’t understand your emotions. Try making a simple record. Every time a symptom occurs, write down what happened in the previous half hour and how you felt at the time. You don’t need to write it beautifully, even if it is “I was very angry when my boss scolded me just now” or “I felt wronged when I quarreled with my partner just now”, it will be useful to write it down. Oh, by the way, there is one more basic premise: Go to a regular hospital to check for organic problems first if you have symptoms. Don’t feel like you are suffering from a physical problem. If there is something wrong, if you delay, you will be in trouble.

After doing psychological counseling for almost five years, I found that most of the people who suffer from somatization are usually too "sensible" people. They take care of everything themselves, are too embarrassed to trouble others, and never talk about their emotions. They always feel that "this trivial matter is nothing, just get over it." As a result, in the end, the body can no longer bear it and sends you a signal first.

In fact, you really don't have to force yourself to be an "emotionally stable adult". Emotions are not that scary, and crying out for pain is not a sign of weakness. If you speak out what's on your mind, your body won't have to cry out for you.