Somatization-Psychosomatics

Abstract

Understanding psychosomatic disorders implies on the one side the information processing abilities of the brain and on the other side the affective dimensions of a subject. The Paris School of Psychosomatics considers the origin of psychosomatic illness as an excessive drive and physical sensation that cannot be thought about and made sense of, the so-called speechless mind. Patients with psychosomatic disorders have great difficulties to fantasize and express feelings, demonstrating emotions in somatic manifestations. According to the attachment theory, somatization is the failure to build up a secure attachment in infancy; in early development, the integration of the sensory, visceral, and motor excitations with images and words does not take place. Both theories contain the idea that psychosomatic illness results from disturbances in early development. In children, psychosomatic symptoms are relatively frequent as children are not as able as adults to separate psychic conflicts from somatic sensations. Somatic dysfunction without detectable somatic substrate may show up in motor, sensory, visceral, and other functional areas. For the assessment of psychosomatic symptoms in infants and young children, it is essential to consider developmental aspects. Psychological distress may have a visible or sometimes more hidden impact on the body. A clinical vignette illustrates a psychotherapeutic intervention with a child presenting psychosomatic symptoms.