Somatization Disorders: Understanding Psychosomatic Illness




James, 14 years old, was recently admitted for symptoms of sudden blindness. He was in the hospital for five days and underwent several diagnostic tests to determine the cause and extent of his loss of sight. On the third day, the doctors did not find any organic pathology from the tests wherein all returned with normal results. James was transferred to the adolescent psychiatric unit for further evaluation of conversion disorder. During the nursing assessment and interview, James demonstrated a matter-of-fact attitude when asked about his blindness experience. When the nurse interviewed the mother, she confided that James got reprimanded and hit by his father, told negative and other degrading words. This violent environment has been going on since James was five years old.


What is Somatization Disorder?

“Somatization disorder, characterized by a history of at least eight unexplained symptoms in four or more bodily systems, represents the extreme end of a continuum of somatoform severity.”  Richard J. Brown, Ph.D., Clin.Psy.D explains. As early as the 1800s, the idea of mind-body connection was well accepted in the causation of physical symptoms secondary to psychological conflicts. Experts believe that the mind is capable of transferring unwarranted feelings into physical manifestations when confronted with distress, anxiety and other forms of mental disturbances. This is where the word psychosomatic illnesses began.

Accurate enough, certain medical diseases are linked to stress and fatigue like cardiovascular disease, stroke, diabetes, and some gastrointestinal conditions. However, if the person continues to experience severe and traumatic situations coupled with the maladaptive coping mechanism, these symptoms will prevail and can worsen in time. Some individuals would be reporting several pain symptoms all at once, unexplained pain in the different parts of the body, and appears to be anxious and restless to know every symptom there is. Sigmund Freud theorized that these persons are converting their psychological problems into physical symptoms, and is now called somatization.




Types of Somatization Disorders

Somatic illnesses are seen in persons that have the following manifestations:

  • Physical symptoms that appear to be a significant medical illness, yet no organic basis as seen in diagnostic and laboratory tests.
  • Any stressful situations can almost trigger, aggravate, intensify, and maintains the symptoms.
  • Persons having these symptoms do not willfully cause them to happen, i.e., it’s beyond their conscious control.

Somatic symptom disorders are categorized into the following terms:

  1. Somatic Symptom Disorder. The condition is manifested as one or more physical complaints with no organic basis. Despite this assurance, the person is occupied with their current state and appears to be insignificant distress worrying about it.


  1. Conversion Disorder. In the case study presented in this article, James has a conversion disorder, and it’s being manifested as blindness. For an average individual to experience sudden illness, this can be an alarming situation. Nonetheless, those who have conversion disorder would display la belle indifference or lack of concern on the functional loss. The most common symptoms fall under sensory or motor deficits like loss of hearing and paralysis.




  1. Pain Disorder. For persons with this type of somatoform condition, their major presentation is a pain in several locations of the body. They are not quickly relieved by analgesics and are much affected by problems and stressful situations. “Just like our feelings give us information about our needs, so do our bodies through physiological feedback,” says Eliza Chamblin, LCSW.


  1. Hypochondriasis, also known as illness anxiety disorder, is a combination of disease conviction and disease phobia. The person believes and would argue that he has a severe medical condition and will soon perish if not attended. These individuals would go into “doctor shopping” business and will get as many medical evaluations or professional opinions until they are satisfied with what they are hearing. The problem, nonetheless, is they seem not to be happy with any of the medical views and health assurances that are provided for them; thus, the condition persists. That is the reason why Sal Raichbach, PsyD states that “Sadly, only a small percentage of people actively seek professional help for their mental health problems.”