PSYCHOSOMATIC, SOMATO-PSYCHIC, AND PSYCHO-SOCIO DISORDERS
In the following, I describe these three conditions, the first of which is widely known, the second two much less so. I link these to insights from energy psychology.
The notion of a psychosomatic disorder is commonplace. A disturbance or conflict in the mind is transposed to a disturbance in the body. In contrast to functional or ‘hysterical’ states, the damage in the body is real. In the simplest forms of this, we might think of the way in which stress impacts the body – the effects of chronic flooding of the body and brain with stress hormones.
Deeper and more subtle forms of psychosomatic disturbance occur when the stress appears relatively absent from the mind but is expressed in the body through mechanisms that are completely unconscious. In the course of psychoanalytic work, the unconscious emotions may begin to percolate into awareness – although the full translation of a somatic disturbance back into a psychic disturbance is often elusive. It seems that once a psychosomatic illness has begun it is not always easy to reverse this process fully.
Work with the subtle energy meridians in energy psychology can be very revealing of how these processes occur. There are twelve main meridians and two additional vessels. The twelve meridians all have traditional body links, either to bodily organs or to bodily systems. If we use kinesiology energy testing, it is possible to find which meridians are particularly involved in a problem. Sometimes a client will present with a feeling of pain in an area of the body (but not necessarily indicating a fully developed clinical condition) and energy testing will reveal that a meridian linked to the organ in that area of the body is key to the picture. So, for example, feelings of pain and tension in the chest (when not due to an actual cardiac dysfunction) may turn out to be particularly linked to the heart meridian and the pericardium meridian. Similarly, gut problems may involve the stomach meridian, small intestine meridian, or large intestine meridian. Experiences that are felt to be to be toxic, in the sense of impossible to digest and metabolise, may be signalled through the liver meridian. Rage may show up in the gall bladder meridian.
What becomes vividly apparent in forms of energy psychotherapy that explore the functioning of specific meridians in relation to specific bodily and mental states (for a particular individual, not as generalised patterns) is the way in which protomental states may move either into emotional expression in the mind or may be channelled down through the meridians into the body. When the latter happens, the person may be left with little conscious awareness of the emotions that have been diverted into the soma.
A healthy emotional state, of course, involves a temporary expression in both mind and body, a dynamic expression of thought, feeling, and body state, that has a flowing energy to it, arising and dissipating.
For example, a man regularly woke with feelings of pain in his chest and a sense of agitation and foreboding about the day ahead. Medical doctors had not found any physical reason for the pain. It was only after considerable energy psychotherapy, over a relatively long period of time, that we were able to make more direct contact with his intense and raw rage and the early experiences that had provoked it.
Of course, any persistent or severe somatic symptom should be fully investigated by medical doctors.
A psychosomatic condition that is not often recognised as such is that of severe depression. This tends to be triggered by a painful or traumatic event, which the person cannot fully process emotionally. Anger and other emotions are channelled down the meridians and into the body, creating a state with strong organic and biological components, often with considerable sleep disturbance. In some cases the person loses conscious knowledge of the link with the precipitating event, whilst in other cases there is partial but not full awareness.
SOMATO-PSYCHIC CONDITIONS
These are less commonly recognised, and indeed are often misperceived as psychosomatic. The term somato-psychic is one I introduced in my book on ADHD and autistic spectrum states (Mollon, 2015), to denote somatic conditions that have pervasive psychological effects. The particular example I give is that of hypermobility or Ehlers Danlos Syndrome (EDS) – a condition that actually has some correlation with ADHD. This syndrome involves a pervasive systemic deficiency in the collagen structure of the body. A wide range of symptoms follow from this excessive flexibility – joints dislocate, widespread fibromyalgia-type pains, gut problems, vascular dysfunction, cognitive problems resulting from impairment of blood flow to the brain, pain for women during intercourse, and chronic anxiety and feelings of stress. The EDS body is constantly under stress and in pain, since it is literally in danger of falling apart and has to keep working to hold itself together through its musculature. This results in unpredictable surges of stress hormones, provoking panic attacks ‘out of the blue’. Living with this condition and its associated pain may contribute to depression. Years of failure to obtain a correct diagnosis, and myriad misdiagnoses, all further add to a burden of emotional pain that may sometimes overwhelm the person. What tends to happen is that since the symptoms are widespread and varied, the person is referred to various specialists, each concerned with different parts of the body or brain, without anyone connecting the dots and seeing the whole picture.
There are many other somato-psychic conditions, such as Lyme disease – a pathogen-based illness originating from a bite from an infected tick. If not rapidly and vigorously treated, it can become chronic, giving rise to a wide range of physical and psychological symptoms. It is known to be both widespread and grossly under-diagnosed.
PSYCHO-SOCIO CONDITIONS
In a psychosomatic condition, an emotional perturbation that could potentially be experienced and expressed at the mental level is instead channelled into the body. By contrast, in what I call a psycho-socio condition the disturbance is directed neither into the mind nor the body but into the wider society. A person with this condition will create a disturbance ‘out there’ in the social world. Acts of aggression are directed outwards – in delinquent vandalism unconsciously designed to transfer and transform an inner disturbance to one that is expressed in the outer society. There are many forms this can take, often accompanied by rationalisations of its true nature.
It may be hypothesised that the fundamental but unconscious perturbation in human beings is the sense of entropy that is inherent in all life – as soon as we are born we are on a trajectory towards death. Melanie Klein observed that even as infants, indeed particularly as infants, we fear the pull of death within and continually try to get rid of this, locating it ‘out there’. Nurturing care and the presence of love help to ameliorate these terrors, but they never fully leave us and we are continually driven to project them by creating disturbance ‘out there’. As a species, we are paranoid.
A common variant of the psycho-socio condition occurs when a particular individual, such as a sibling or other relative, or a co-worker, or a neighbour, is unconsciously selected to be a recipient and container of the unwanted disturbance. This involves processes of projective identification, whereby the target person is manoeuvred (sometimes subtly and sometimes crudely) into experiencing the unwanted disturbance – the agent of the projection then feeling free of it, albeit compelled to continue this unconscious interpersonal strategy. In this way, states of anxiety, depression, or feelings of guilt and shame and inadequacy, are forcibly evoked in the other so that they are not felt in the self.
In all these conditions, the healthy state to strive towards is one in which we feel our perturbations clearly within ourselves and face them. There is much to be perturbed about. If we do not feel perturbations at the level of human experience here on the earth, then we are doing something unconsciously to export them – into the body or into another person or into the wider society. At a very high level of meditative consciousness, there is no perturbation since all is perceived as perfect and there is no duality – all that seems most adverse is recognised as playing a role in the perfection of the whole. However, we cannot live in such a meditative state indefinitely whilst still functioning in physical and social reality.
Reference:
Mollon, P. (2015). The Disintegrating Self: Psychotherapy with Adult ADHD and Autistic Spectrum. London. Karnac.
Phil Mollon
Psychoanalyst and Energy Psychotherapist