About Psychosomatic Psychiatry
(Psychosomatic Medicine)
When we say,
“The heart is sad and the body becomes weak,”
we are in fact pointing precisely to the core concept of Psychosomatic Medicine —
an interdisciplinary field of medicine that studies the relationship between the mind, emotions, and the body.
This field shows that psychological experiences can manifest as real physical symptoms.
1. Definition of Psychosomatic
The word psychosomatic comes from two Greek roots:
- Psyche = mind
- Soma = body
Thus, psychosomatic refers to:
The interaction of psychological processes (thoughts, emotions, stress) with the physiological functioning of the body.
Physical signs and symptoms whose primary cause or aggravating factor is psychological.
In this approach, illness is neither purely biological nor purely psychological; rather, it is the result of the interaction of three levels:
- Biological factors (genetics, neurobiology)
- Psychological factors (emotions, conflicts, coping styles)
- Social factors (relationships, environmental pressures)
This is the Biopsychosocial Model, proposed by George Engel in the 1970s.
2. Biological Mechanisms Linking Mind and Body
How do emotions turn into physical symptoms? There are several main pathways:
1. Hypothalamic–Pituitary–Adrenal Axis (HPA Axis)
Psychological stress → activation of the hypothalamus → release of CRH → ACTH → cortisol
Results:
- Immune suppression
- Chronic inflammation
- Metabolic changes
2. Autonomic Nervous System
Chronic stress leads to:
- Increased sympathetic activity
- Increased heart rate
- Elevated blood pressure
- Muscle tension
3. Immune System
Negative emotions can:
- Increase inflammatory cytokines
- Exacerbate inflammatory diseases
The field that studies this interaction is called Psychoneuroimmunology.
3. Classical Psychosomatic Diseases
In traditional medicine, the term was used for conditions clearly linked to stress, such as:
- Asthma
- Peptic ulcer
- Ulcerative colitis
- Rheumatoid arthritis
- Hyperthyroidism
- Neurodermatitis
- Essential hypertension
Today, a broader spectrum is recognized:
- Irritable Bowel Syndrome (IBS)
- Tension headaches
- Fibromyalgia
- Chronic pain
- Chronic fatigue
- Certain skin disorders (psoriasis, eczema)
4. Psychosomatic Disorders in Psychiatry
In DSM-5, the terminology has evolved and includes:
Somatic Symptom Disorder
Real physical symptoms + excessive preoccupation with illness
Illness Anxiety Disorder
Fear of having a disease without significant symptoms
Conversion Disorder
Conversion of psychological conflict into neurological symptoms, such as:
- Paralysis
- Blindness
- Non-epileptic seizures
5. The Role of Repressed Emotions
Early psychoanalysts such as Franz Alexander believed that certain emotions, if not expressed, are transferred to the body.
For example:
- Repressed anger → hypertension
- Chronic anxiety → gastrointestinal problems
- Unresolved grief → fatigue and pain
Today, this view is considered somewhat simplified and has been replaced by more complex models.
6. The Emotional Brain and the Body
Brain regions involved in this connection include:
- Amygdala → fear processing
- Hypothalamus → stress response
- Insula → bodily awareness
- Cingulate cortex → pain processing
For this reason, pain or illness is not only a physical experience, but also an emotional experience.
In everyday life we observe:
When we are happy, even if ill, we perceive less pain.
7. Treatment in Psychosomatic Medicine
Treatment is usually multidimensional:
Medical Treatment
Managing physical symptoms
Psychotherapy
Especially:
- Cognitive Behavioral Therapy (CBT)
- Psychodynamic therapy
- Mindfulness-based therapies
Body-Based Interventions
- Relaxation techniques
- Biofeedback
- Meditation
8. A Philosophical Note
Psychosomatic medicine brings us back to an ancient medical truth expressed by Hippocrates:
“The body cannot be healed without understanding the soul.”
Or more simply:
When the psyche is wounded, the body begins to speak.
“Society and Mental Health”
Here, writings and materials related to psychology and psychiatry are shared.
🆔 ID:
https://ble.ir/jamehvasalamtravan
Dr. Hamid Yousefi
Psychiatrist
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