There are people who Somatize the bodily symptoms excessively. Others, however, may develop a painful illness without noticing any symptoms. How are these extremes explained psychologically?
In psychiatry, somatization refers to the relationship between perceived physical symptoms and their identifiable physical origin. There are people who may tend to over Somatize bodily symptoms (the extreme case would be hypochondria). The opposite happens to other people, they may not perceive the symptoms when a disease is occurring even when it is very painful. How are these extremes explained psychologically?
These forms of somatization can come from internal conflicts that have to do with our relationship with the soma, our bodily matter.
These conflicts are therefore those that can lead to certain people not registering at any time, for example, the creation of a herniated disc until it becomes disabling; or that others feel their pain amplified to unbearable limits, without injury; or even to occur the phenomena referred to as phantom limbs, for which amputated limbs continue to be felt.
THE SOMA AND SOMATIC CONSCIOUSNESS
When we speak of soma, we refer to our body matter, but is that the body that humans deal with on a daily basis? It is not clear that this is the case. So how many bodies do we have? Most people think only one.
However, the thing is not so obvious if we think about the subjective image, we have of ourselves or the distorted perceptions that we have of the real internal organs.
We put the kidneys where they don’t belong, or we think we have a perfect back, when, in fact, it is crooked. Those other bodies are not without consequences in our lives.
The psychoanalyst Jacques Lacan said that we had two bodies: one naive, naive, the one we think we have; and another, the one left in the coffin. Behind this somewhat macabre word, it would seem that it refers to the biological body. However, the ritual of burial also suggests the order of culture, of society, and this although the rites vary in different communities or civilizations. So, are we two or are we three bodies?
We have three body records that will always be present in our lives:
- The biological proper that imposes its laws and limits on organic functions
- The one that has resulted from all the identifications resulting from interrelations with others and that we call myself
- He who has been left without an external image, without entering the mirror and who remains in the background. The latter would correspond to that still weak and dependent part with which we have a permanent self-criticism, but which also has characteristics and qualities unexplored until then.
To understand this division a little better, but also its combination and how it affects us, we are going to turn to the way in which a human offspring is constituted:
- Unlike animals, our creatures are born with a motor and neuronal immaturity that makes them absolutely dependent on adults.
- It will be our care and words that help them to build an image of unity and psychic and bodily identity. Where the baby still does not know if the feet are his or an external object, a unification is established through his name and the interrelationships with the human.
- The model would be the moment when the child recognizes himself in a mirror as being that external but unitary image of himself. It is fictitious, because it only reflects the external, but it is also real, because it offers a totality that did not exist. He is that! And hence the infantile omnipotence, despite its fragility.
These three registers and the relationships between them can serve as a compass to face possible somatizations.
FROM HYPOCHONDRIA WHEN FEELING NOTHING
Depending on which part is more present, or more in conflict with each other or others, we can tend to over Somatize the bodily symptoms (the extreme case would be hypochondria) or, on the contrary, to have a high tolerance to pain (in in this case the extreme degree would be masochism).
- The tendency to hypochondria. If we move, most of the time, in the line of exhaustively controlling what can happen to our organism, trying that nothing escapes us and that it fits into a perfect frame, we are moving in that rejected part of supposed failures, which we want to dominate and that we confuse with the physical organs.
- The tendency not to feel pain. If what predominates is an assimilation to the figure in that ideal mirror, the effects that we can find are various. It may be the case in which the body itself reacts with eczema, hair loss, small infections, etc. Symptoms that are not usually very serious, but that speak of something that is degrading your image. The person cannot bear a negative perception of himself, and when he has had to do, think, say or even dream something inappropriate, guilt leads him to punish himself, through the body, in some way.
WHAT HAPPENS TO PEOPLE WHO SOMATIZE EXCESSIVELY?
Those we commonly call hypochondriacs are those who, in the face of any type of symptom – or even hear it in some medium, friend or relative, of any medical term that refers to a disease – think and feel that they have it themselves and that, Furthermore, he will have no remedy and will lead him to death.
- In the vast majority of cases, they will be people who will need to consult one or more doctors, to confirm that they have nothing, or that what they have is very slight and temporary.
- To a maximum degree, we find those who can feel immense, unbearable pain in an organ, to the point of ending up in the emergency room or hospitalized. It really hurts them, but that suffering comes from an image of a part of their body that they experience as injured and bad.
- It is not strange to see in these patients that the crisis may have begun to develop as a result of an episode of a family member or friend and that it ended in a fatal way.
- The sadness or loss has become identification, but embedded in his own body. The unconscious idea that underlies these phenomena is to anticipate and master, even with medical help, the different vicissitudes, present and future, that can happen to our bodies.
May that figure of completeness that we think we need to be happy never fail us. An impossible task, no doubt, because it is exposed to the deformation of the mental image that we have, and not to the true path and functioning of our body matter.
WHY DON’T OTHER PEOPLE FEEL PAIN WHEN THEY SHOULD?
In the opposite field we find people who seem to be anesthetized for pain. Subjects who may be producing a stomach ulcer, a hernia, or have their teeth crushed, but that does not create problems until they are very serious.
In these anesthetic cases what we have is just the inverse of the previous structure. People are very identified with that image of Unity that the mirror gives them, and they have very little contact with the part of them that does not enter that complete figure. That means that they will connect very little both with self-criticism, as with the reality of their living organism.
They don’t need to control because, supposedly, everything is already controlled. But of course, here we also see how the interference of our psychological portrait does not allow us to appreciate what may be truly happening in our organism.
What happens then to those who have suffering as their standard? Well, we are subdivided into two. Those people who believe that being a good mother, daughter or worker goes through the maximum sacrifice, that is, they have the ideal image of suffering to fulfill their functions; and those that use pain as an erotic form, but where at no time will their lives be at risk, but rather play with those limits offered by the bodily members that provide them with an imaginary image of pleasure.
Other cases, within that same section, are those of subjects who completely ignore the needs and physiological rules, and this to the point of being able to generate serious injuries that can become incurable.
The reason is that either because they have an exaggerated ideal of sacrifice, or because they believe that only by suffering can things be done well, or because they do not want to feel limited by anything or anyone, the result is that of a total alienation with respect to those elemental needs. Contacting these deficiencies is what can allow us to fill them and not deny them.
CAN SOMATIZATIONS BE CONTROLLED?
Our body diagrams have been built over time and it will depend a lot on how we have been including the different parameters of its constitution.
In general, we tend to look for that totalizing unity that brings us down the street of bitterness. We pretend to be and be perfect or perfect before ourselves and before others. That there are no cracks, no mistakes, no contradictions and to achieve this we are always controlling and self-censoring ourselves.
Permanent tension is served and the possibility of turning any element of our lives into anxiety and somatizing can be a way out.
Obviously, we are going to find different ways and degrees of exposing our bodies to these conflicts. In all cases we verify that it is a matter of trying all the time to make our bodies coincide with that imagined figure that satisfies us, but leaves out the other psychological and physical components involved in our human structure.
Of course, the division of our body into 3 that we talked about at the beginning is totally unconscious and we all believe we have only one, the one we identify with the internal container with respect to what is outside of it, the exterior. However, in our day-to day lives, we observe ourselves both externally and internally, and we comment on ourselves. We are telling each other how we look, and how we feel.
We are observers and the observed at the same time. In this dynamic we would have to become aware of the type of dialogue we have, what messages we are giving ourselves and what image we are prioritizing.
We must consider that the three bodies are interrelated. To the biological one, to the extent that we do not have direct access to our organs, we must do a medical review from time to time. When looking for the perfect Unity in the mirror, you have to set limits. And on the critical side, which is not perfect and which we reject, we must listen to it because in it we can discover characteristics of ourselves that are very interesting. Maintaining a balance between the three would be ideal.
The idea would be the way to balance them, but not to find again a supposed ideal image, but to be able to take them into account and weigh them in each moment and context, which of them would be more effective, instead of denying them.