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Somatic pain: is it all in your head?

Updated: Feb 10, 2020

Gabor Mate is an expert on overcoming the long-term effects of trauma. I recently came across a quote of his that explains the intersection between emotional and physical illness brilliantly:

When you shut down emotion, you’re also affecting your immune system, your nervous system. So, the repression of emotion, which is a survival strategy, then becomes a source of physiological illness later on.”

I couldn’t agree more. Sadly, he’s one of very few of us proclaiming these powerful truths.

My experience is that the fields of mental health and medical science have only scratched the surface of understanding the impact of trauma holistically, and we’ve done even less toward developing effective forms of treatment to overcome it.

The professional who doesn’t understand trauma will often come to false conclusions about their client’s needs, diagnosis, prognosis, and whether medication is required. A very high percentage of the survivors I’ve treated were misdiagnosed as living with Bi-Polar disorder, Attention Deficit Disorder, and even Pervasive Developmental Disorders.

Professionals who tend to have the greatest accuracy are those who invest the time in getting to know those they serve. They screen for ACEs, sexual assault, substance use disorders and other common co-occurring conditions like eating disorders and self-injury.

The mindful practitioner will also consider the physical health of their patient and what it indicates. Bessel Van Der Kolk summed this phenomenon well in “The Body Keeps the Score.”

Too often, medically trained professionals conclude that we live with chronic pain that it is “somatic” in nature.  This means that the pain may indeed feel real, but it is not caused by physical illness. It is viewed as a product of imagination/excessive worry, or mental illness.

Survivors of traumatic experiences tend to have significant health problems that are in fact a direct result of untreated trauma (acid-reflux, IBS, chronic neck/shoulder pain, migraines).

There are also a plethora of conditions that aren’t caused by anxiety, but which are exacerbated by it. (Chron’s disease, diabetes, asthma, sleep apnea).

I’m not medically trained, so my advice to those who live with physical pain is simple: By all means, see your doctor. Get the tests done. AND while you’re going through all that, try some journal writing, ask your loved ones directly for support, and go do some body work (yoga, massage therapy, chiropractic, acupuncture).

Very often, incorporating forms of release into our lives creates improved health outcomes in short order.

I urge folks to go back to basics: nutrition, hydration, exercise, socializing, and fellowship. The things that always benefit us are too often things we don’t sufficiently invest in.

My challenge to folks who live with anxiety: invest more time and energy into coping and basic needs fulfillment. Stay away from self-diagnosis and Web MD. Consider therapy with someone known to have expertise in trauma recovery.

Anxiety is absolutely treatable, and in many cases, curable.

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