Your body speaks what you silence. The phrase sounds simple, but understanding somatisation goes far beyond popular wisdom. In practice, it is a psychological, emotional, and physical process that reveals what was never named—never fully felt. In everyday language, somatisation is seen as the expression of emotional conflict through physical symptoms. All the anguish of the mind seeks refuge in the body. This is why so many people live with recurring pain, never suspecting that what truly hurts isn’t the body, but something deeper: what was left unsaid.
Medicine and psychology have long tried to define somatisation in many ways. Psychiatrist Lipowski (1968) described it as “the tendency to experience, conceptualise, and/or communicate psychological states as bodily sensations, functional changes, or somatic metaphors.” Kellner (1991) stated that somatisation involves physical symptoms without detectable physical disease. In other words: there is pain, but no visible diagnosis. Yet it exists. It is there. It demands to be heard.
The complexity of somatisation lies exactly where emotion and physical symptom become entwined. It’s a territory where psychic pain finds its expression in the body—because words failed, because consciousness could not process, because feeling was interrupted.
What is somatisation?
Somatisation is the process where emotional conflicts are expressed as physical symptoms, often without a detectable medical cause. All the anguish of the mind seeks refuge in the body. This is why many people suffer recurring pain, fatigue or illness without suspecting that the true pain is not in the body, but in something deeper—what remains unspoken.
Medical and psychological definitions have evolved. Psychiatrist Lipowski (1968) called somatisation “the tendency to experience, conceptualise, and/or communicate psychological states as bodily sensations, functional changes, or somatic metaphors.” Kellner (1991) wrote that somatisation means experiencing real symptoms with no physical diagnosis. It is real, it is present, and it demands to be heard.
In psychoanalysis, Freud explained somatisation as unconscious conflict “converted” into bodily symptoms—never faked, but a deep defence mechanism. Recent theories (Bucci, 1997) see it as a disconnect between what is felt and what is spoken: the body keeps the score when feelings cannot become words. Neuroscience agrees: the body feels first, the mind understands later (Taylor, 1997).
What are the main symptoms of somatisation?
Common symptoms include:
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Persistent muscle pain
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Chronic gastritis or digestive issues
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Headaches or migraines
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Unexplained fatigue
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Dizziness, palpitations, insomnia
These are often bodies trying to communicate what the mind hasn’t yet processed. These symptoms are real. The person is not pretending, nor are they aware of the process—only that they are suffering.
How can somatisation be prevented?
Prevention is about emotional awareness and integration:
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Learning to recognise, name and accept emotions as they arise
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Encouraging environments (in families, schools, workplaces) where feelings are welcomed rather than silenced
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Body-mind practices such as mindfulness, yoga or breathwork
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Psychotherapy or counselling to process emotions before they become physical symptoms
Children especially need space to express anger, sadness, fear—emotions traditionally silenced or dismissed.
How is somatisation treated?
Treating somatisation requires both medical and emotional care:
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Always rule out physical causes with appropriate medical exams and tests
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If no cause is found, consider psychological roots—without blaming the patient
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Psychotherapy (especially approaches that integrate body and mind, such as psychodynamic therapy, CBT, somatic therapy)
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Mindfulness and conscious body practices to reconnect emotion and sensation
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Naming and validating emotions, opening space for presence and healing
The process is gradual and requires patience and support. Medical treatment should never be abandoned, but a broader perspective allows true healing.
Why do people somatise?
Because so often, we learn to silence our feelings. Society teaches us to be strong, rational, and productive—but not to feel deeply. When there is no space for emotion, it finds refuge in the body. The body, in turn, speaks.
In psychoanalytic theory, somatisation is linked to Freud’s idea of conversion hysteria. Freud (1894) proposed that unconscious conflicts, intolerable to the conscious mind, are converted into physical symptoms as a symbolic way of dealing with suffering. It is not invention or play-acting: it is a profound defence mechanism, often unconscious.
More recent theorists, such as Bucci (1997), have broadened this understanding. For her, somatising is the result of a disconnect between verbal and non-verbal representational systems—what we feel in the body does not find symbolic translation, does not become word, and so remains in the body as tension, pain or illness. This model suggests emotional dissociation prevents full integration of feeling and understanding.
Neuropsychology confirms this: emotions are physical experiences before they are cognitive. Taylor (1997) suggests the body feels before the mind understands. So when emotional conflict is not processed or expressed, it can show up as real physical symptoms.
Persistent muscle pain, chronic gastritis, migraines, unexplained fatigue, dizziness, palpitations. In many cases, these are bodies trying to communicate what the mind could not yet process. These are deep messages from the soul.
And no, the person who somatises is not pretending, nor are they aware they’re doing it. They truly feel the pain. But they cannot name its origin. The body becomes the channel of expression.
This happens because we so often grow up learning to keep silent. Not to feel anger, or sadness, or frustration. We are taught to be strong, productive, rational. And when an emotion has nowhere to exist, it seeks refuge in the body. The body, in turn, speaks.
The great challenge with somatisation is recognising this dynamic. While the focus is only on the physical symptom, the cycle repeats. This is not about abandoning medical care—on the contrary, it is essential—but about expanding our view. Maybe that pain in your chest isn’t only a heart problem. Maybe the insomnia isn’t just too much coffee. Maybe your gastritis has something to say.
Dealing with somatisation requires listening. Not only medical listening, but emotional listening. Psychotherapy, body-based awareness, naming emotions, making space for feeling. This is a process. It takes time, support, and courage.
Because feeling also hurts. But it is in this pain—felt with presence—that healing begins. The body speaks. The question is: are you listening?
FAQ:
What is somatisation?
A: It’s the process where emotional conflicts are expressed as physical symptoms, often without a clear medical cause.
Q: Is somatisation real or imaginary?
A: It is very real. The person genuinely experiences pain or symptoms, even when tests are normal.
Q: What are common signs of somatisation?
A: Persistent pain, fatigue, headaches, stomach issues, palpitations—without a clear physical cause.
Q: How does psychology explain somatisation?
A: It is seen as a defence mechanism; emotional suffering finds expression through the body when it cannot be named or processed.
Q: How can somatisation be addressed?
A: Through medical support, psychotherapy, naming emotions, and developing body-mind awareness. Healing is possible with time and presence.
References
Lipowski ZJ. (1968). “Somatization: the concept and its clinical application”.
Kellner R. (1991). “Somatization: theories and research findings”.
Bucci, W. (1997). “Psychoanalysis and Cognitive Science: A Multiple Code Theory”.
Taylor GJ. (1997). “Somatization and the Psychosomatic Bridge
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