(AGENPARL) – mar 13 dicembre 2022 By Marialuisa Roscino
Anxiety-related somatisation can hide problems related to the expressive sphere and the ability to communicate one’s thoughts. When the body somatises and anxiety symptoms are evident, what can be done? And when is it really necessary to intervene? We asked Dr Adelia Lucattini, Psychiatrist and Psychoanalyst of the Italian Psychoanalytic Society and the International Psychoanalytical Association.
Dr Lucattini, when to understand if one is somatising? And when to intervene, so that psychosomatic disorders do not actually turn into pathologies?
Psychosomatic disorders result from a deep psychological malaise that causes physical symptoms in the absence of physical illness. It can affect any part of the body. People suffering from these disorders because they have pain, burning, itching, etc., often turn to both their family doctor and specialists, becoming very alarmed at what they feel is a lack of diagnosis. Once all the investigations have been completed, which is always the first step, and nothing organic appears, one has to think of a psychosomatic disorder.
It is essential to intervene early, through early diagnosis. In fact, once it has been established that the disorder is psychological in nature, the only effective treatment is psychoanalysis, which makes it possible to understand what are the deep, unconscious reasons that cause anguish, anxiety and depression, which are not felt in these cases, at an emotional level, but are instead, discharged onto the body.
When does anxiety take over the throat? A psychosomatic sore throat normally manifests itself with what is called a knot in the throat or and feeling of constriction. Dr Lucattini, what is the cause of symptoms, defined as ‘psychosomatic’ in these cases?
These types of symptoms are very frequent. The sore throat, the feeling of not being able to swallow (‘bolus’), are mainly manifestations of anxiety. When one is tense, anxious or distressed, the body reacts by releasing adrenalin and cortisol into the blood. In addition to increasing heart rate and blood pressure, these hormones cause rapid, shallow breathing, mouth breathing, muscle tension, a burning sensation in the throat, sore throat, and dry mouth.
Mind and body are deeply united, the person is one, any psychological stress, sorrow, worry, suffering, if they are not conscious, are expressed through the body. Knowing one’s own problems, is anxiolytic in itself and allows one to solve them.
Dr Lucattini, anxiety-related somatisation can hide problems related to the expressive sphere and the ability to communicate one’s thoughts, what can you tell us about this?
The difficulty in recognising, distinguishing and expressing one’s emotions is defined as ‘alexithymia’ from the Greek ‘a-lack’, ‘lexis-word’ and ‘thymos-emotion’, i.e., the lack of words to express one’s emotional state. This emotional dysregulation can cause psychosomatic disorders as sufferers express their emotional distress and mental suffering through physical pain.
What is the significance of retching and vomiting?
â??Cyclic vomiting syndrome’ is a common condition in children between the ages of 3 and 7 years but is also found in adults. Recent studies have shown that this disorder is closely related to migraine and a family history of headache.
There is, however, a form of nausea and vomiting that is only psychological in nature; they are linked to the denial of the situation one is experiencing, which is symbolically ‘rejected’. Phobias can also manifest themselves with nausea and vomiting as somatisation of fear.
Dr Lucattini, is there a time frame for psychosomatic illness? Generally speaking, how long can it last?
For one to be able to speak of psychosomatic illness, symptoms must persist for at least six months, even if not continuously. The duration depends on the underlying motivation and its duration. If the worries persist and are intense, the physical symptoms will be severe. Anxiety and concern for one’s health, the time and energy devoted to symptoms and worries, and to doctor’s visits also have a great influence on duration. As a matter of fact, the disease only gets better if one starts a psychoanalytic treatment. The sooner one starts, the sooner one gets better.
This type of disorder can actually affect not only the throat, but several parts of the body, such as: the face, (deep acne, eczema, psoriasis, atopic dermatitis, itching, hives, dry skin and mucous membranes), the head (headache, tingling, nervousness, burning scalp), the stomach, the liver, sometimes even the legs, the hands, when in case of fear, shaking or excessive sweating, the heart (tachycardia, chest pains etc. ). So, in all these cases, when the body somatises and the symptoms of anxiety are evident, what can be done?
Once the physical symptoms have become chronic or there are over-infections from scratching, effects from prolonged use of symptomatic drugs, etc., it is necessary to consult a specialist. Of course, with the support of one’s psychoanalyst and an understanding of the causes and meaning of the symptoms, recovery is quicker and the resolution of the physical symptoms, definitive.
In adolescents in particular, these disorders may be more frequent, what can you advise them to cope with?
In adolescents, these disorders are often underestimated or neglected. If they are not stemmed quickly, they can have serious consequences. Adolescents who suffer from somatisation are intelligent, sensitive, very emotional and extremely reserved, withdrawn, inhibited, stuck. They are rarely agitated and excitable, but it can happen. They all have difficulty talking about themselves and their emotions, they cannot manifest their needs and desires. The various symptoms always occur in particular situations and are often recurrent or cyclical. They appear most often during school time due to pressure and stress, when negative recurrences (bereavement, loss, trauma, etc.) as they become depressed.
Knowing that physical pain is often an expression of emotional distress, however
talk to the parents right away and ask to see the paediatrician or family doctor.
Try to understand if there are triggering factors (questions, fights with classmates, bullying, school difficulties, sentimental disappointments, losses, separations, etc.).
Knowing that the (unconscious) choice of ‘target organ’ is never random, so ask if anyone else in the family suffers from it.
Do not think of the worst, of serious or incurable illnesses, calm down a little and talk about your discomfort.
Somatisation is a kind of ‘materialisation’ of negative emotions, in the body, because they are undigested, unprocessed by the mind.
Symptoms are ‘messages’ that the mind sends to oneself through the body and that want to be heard.
Ask to talk to a psychoanalyst, because if there is nothing into the body, then the problem is only emotive and psychological.