Somatization: It’s not all in your head!

We all know the expression of being kicked in the gut by bad news, and unfortunately most of us have experienced it. That’s an intense example of the brain-gut direction of the gut-brain connection: your brain heard it and your gut felt it.

And those experiences can affect us in the long run too, especially if they are experienced repeatedly. In extreme cases, such as for those who have experienced war, this can result in PTSD (post-traumatic stress disorder) or “shell shock”, as it was called after World War 1. People with PTSD are known to suffer more from cardiovascular, metabolic, and musculoskeletal disorders than the rest of us.

The process of mental and emotional problems triggering physical ailments comes under the general umbrella of somatization. The word is derived from the Greek word soma, meaning body, and the concept is that the body is affected by the mind. So somatisation is generally defined as the tendency to experience psychological distress in the form of somatic symptoms and to seek medical help for these symptoms, which may have been initiated and/or perpetuated by emotional responses such as anxiety and depression. In extremis, it is diagnosed as “somatisation disorder”, which is considered a mental illness that causes bodily symptoms.

We know that PTSD has a huge effect on people’s emotional states, and now we recognize that it often affects their physical health too. We also recognize that traumatic childhood experiences can affect physical health in adulthood. But what if lesser negative experiences affect us on more subtle levels? It makes sense that other traumas can affect us to some degree, even if the trauma is not as dramatic as war, or when we are more vulnerable such as in childhood.

We understand at least part of how this happens. Our experiences affect the biochemistry in our brains. Neurotransmitter science is complex and fluid, but here’s a brief overview. Fear and anxiety trigger production and release of more agitating neurotransmitters: mainly epinephrine (adrenalin) and norepinephrine. These may be helpful if we need to be hyper-alert and to fight or flee, but are agitating when we are sitting at work or at home. Dopamine is important in setting up conditioned fear responses, with larger amounts being released in response to more fearful experiences, and then it helps modulate those responses when they occur.

When things are good, the excitatory neurotransmitters are balanced by calming neurotransmitters. GABA produces a calming effect by controlling the nerve cell hyperactivity that is associated with anxiety, stress and fear. Serotonin has been shown to play an important role in control of anxiety and fear responses.

Researchers have discovered that just thinking about an experience re-triggers the release of those same neurotransmitters that were released at the time, whether positive or negative. And unfortunately the production of those chemicals can become almost habitual: the more we do it, the more our biochemistry is inclined to continue to do it. This makes us feel the negative emotions that then trigger the unhelpful biochemistry, and so the negative spiral can continue.

Candice Pert’s book “Molecules of Emotion” is about this very process. Our brain gets accustomed to the pathways of production, which can almost become super-highways in some people. Many of those who experience this phenomenon become good at masking and living with it, but that doesn’t mean that their bodies are not being affected. Hence the expression being “worried sick”.

The medical effects of PTSD and ACEs teach us that unhappy brain biochemistry can result in unhealthy body biochemistry, that can predispose us to various ailments. It has long been recognised that people can “die of a broken heart”, a classic example of a physical effect from a sad emotional situation. But it doesn’t have to be as dramatic as that. It can be lesser yet still significant experiences, predisposing to ailments such as gastric ulcers (once thought to be solely due to stress), IBS, migraines, or the physical symptoms of a panic attack.

This isn’t to say that everyone who experiences a certain trauma will get a certain disease. It may take a negative synergy of several factors before physical symptoms arise, and trauma can be one of them.

This definitely isn’t the dismissive “It’s all in your head dear”. The concept of somatization is a genuine acknowledgement and respect for the way that human physical systems can be affected by our traumatic experiences. Naturopaths believe in the health and wellbeing of body, mind and spirit, and the constant interplay between these. You can help shift a negative spiral to an upward one via physical or mental-emotional work, even if you don’t know which is cause and which is effect. Exercise and meditation can both help us deal with stress, and become healthier. Doing both is even better!