Somatization (psychology)

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Somatization describes the tendency to ascribe physical malaise and symptoms that cannot be traced back to pathological somatic findings to physical illnesses and to seek medical treatment for them. It is believed that this propensity is often a response to psychosocial stress. Other authors describe that persistent somatization ("somatic fixation") can also play a role in organic diseases. In doing so, the doctor, patient, or family members focus exclusively and inappropriately on the somatic aspects of a larger problem. Somatization is the basis of the term somatoform disorders (F45) contained in the ICD-10 diagnosis code.

Somatization as a consequence of conversion

Somatization
Affect correlate Affect equivalent

According to the theoretical view of psychoanalysis , somatization represents the result of the conversion (transformation) of affects such as fear, aggression, anger, anger, guilt, sexual instinctual wishes on organs. It is thus a process of psychophysical correlation (downward effect). These affects can manifest themselves in erectile dysfunction, blushing, fainting, headaches or migraines or gastrointestinal disorders. These physical symptoms can also be classified as psychosomatic illnesses . In both perspectives, somatization describes the displacement of unbearable psychological states on the physical level in order to experience psychological relief. If the patient is aware of the assignment of his feelings to the physical symptoms, one speaks of an affect correlate , otherwise of an affect equivalent . During the conversion, the affected patient is mostly at least partially aware of the reaction to psychosocial stress (affect correlate), see also: expressive illness . Somatization represents a defense mechanism . Sigmund Freud describes the conversion in 1894 as

"... rendering the incompatible imagination harmless by converting its arousal sum into the physical."

Somatization as a consequence of alexithymia

Somatization as a consequence of alexithymia refers to physical symptoms that manifest themselves in the form that the patient has difficulty adequately perceiving emotions in himself, distinguishing qualities of affect and finally symbolizing them or giving them linguistic expression. The concept of illnesses at the ready also refers to similar causes of psychosomatic illness development in connection with the extensive repression of emotional illness factors (affect equivalent).

Somatization as an iatrogenic fixation

Somatization can also take place partially iatrogenically if, for example, the patient finally develops a fixation on body symptoms without disease value through medical diagnostics and wants to exclude these through repeated exclusion diagnostics .

See also

Individual evidence

  1. ^ Zbigniew J. Lipowski: Somatization: The concept and its clinical application. In: The American Journal of Psychiatry. Vol. 145, No. 11, 1988, pp. 1358-1368, doi : 10.1176 / ajp.145.11.1358 .
  2. ^ A b Hans Morschitzky : Somatoform disorders. Diagnostics, concepts and therapy for body symptoms without organ findings. Springer, Vienna et al. 2000, ISBN 3-211-83508-3 .
  3. ^ Ian R. McWhinney, Ronald M. Epstein, Tom R. Freeman: Lingua Medica: Rethinking Somatization. In: Annals of Internal Medicine. Vol. 126, No. 9, 1997, pp. 747-750, doi : 10.7326 / 0003-4819-126-9-199705010-00037 .
  4. ↑ Sigmund Freud : The defense neuropsychoses. Attempt of a psychological theory of acquired hysteria, many phobias and obsessions and certain hallucinatory psychoses (1894). In: Sigmund Freud: Collected works. Ordered chronologically. Volume 1: Works from the years 1892–1899. (Studies on hysteria and other works from 1892–1899). S. Fischer, Frankfurt am Main 2012, ISBN 978-3-10-022703-4 , pp. 57-74, here p. 63.
  5. ↑ John C. Nemiah, Peter E. Sifneos: Affect and fantasy in patients with psychosomatic disorders. In: Modern Trends in Psychosomatic Medicine. Vol. 2, 1970, ZDB -ID 128880-5 , pp. 26-34.
  6. ^ Thure von Uexküll : Basic questions of psychosomatic medicine (= Rowohlt's German Encyclopedia. Vol. 179/180, ZDB -ID 985674-2 ). Rowohlt, Reinbek bei Hamburg 1963, see Stw. "Stand-ready disease" p. 194 f., 197 f., 200 f., 203 ff., 233 ff.

literature