Psychosomatics – when the body says what we are silent about.

Psychosomatics – when does the body tell us something important? Imagine this: you’ve seen every doctor. You’ve had all the tests. You’ve had an ultrasound, MRI, CT scan, and then you hear, “Everything’s normal. You’re healthy.”
But it hurts. It’s tight. You can’t breathe. It won’t let go. You feel bad all the time, no matter what you do for yourself.

And you’re starting to think, maybe I’m just imagining things? Maybe I’m just weak? Maybe it really is “all in my head”? And it really is, in my head. And that’s called “psychosomatics.” And it’s a completely real condition that can and should be worked on.

It’s very strange when emotions are behind the symptoms.

This is where things get really interesting. Psychosomatics isn’t just “my head hurts from stress.” It can look anything. And often, the connection to the psyche isn’t at all obvious. Here are some examples:

Chronic back and neck pain

Often associated with excessive responsibility, the feeling that “it all rests on me.” “I carry everything on my shoulders” isn’t just a metaphor. Often, during sessions, simply telling a client that they feel like they’re carrying a huge, heavy bag on their shoulders is enough to trigger a bitter cry. This is a sign that the back and neck pain is psychosomatic. Next, we need to figure out who put this bag on their shoulders and why they agreed to carry so much.

Problems with the stomach and intestines

Irritable bowel syndrome, nonbacterial gastritis, chronic nausea—the gastrointestinal tract is extremely sensitive to anxiety and unexpressed emotions. It’s not for nothing that the gut is called the “second brain.” Often, a person’s life is overwhelmed by so many emotions and experiences that the psyche can’t process them all. But for a psychosomatic person, it’s not the psyche that reacts, but the body. It’s the gut, which “fails to process” instead of the psyche.

Choking and feeling of a lump in the throat

When there’s something you can’t swallow (a particular emotion or a state composed of multiple emotions is unbearable) or can’t utter. Suppressed words, unspoken pain, forbidden emotions—all of this literally takes your breath away. A sore throat can also indicate that there’s something difficult or even impossible to express to someone else.

Here, I recommend watching my video about the importance of clearly and specifically communicating what’s important to us. I don’t mention psychosomatics in the video, but I find it very helpful.

Chronic fatigue for no reason

You’re sleeping, but not getting enough. You wake up in the morning, feeling as if you never slept. Your lab results are normal. Your thyroid is fine. But you’re exhausted. Often, this is unnoticed mental exhaustion, which the body translates into physical exhaustion. This usually occurs in people who can’t rest, who never get enough, who constantly need to prove something to others. It’s very easy to double-check this hypothesis—just ask such a person when they last took a full vacation (two weeks in a row or longer). Then send them on vacation and observe their condition afterward.

Skin reactions

Psoriasis, eczema, and urticaria, which worsen during stressful moments, are classic psychosomatic conditions. The skin is our boundary with the outside world, and it reacts when this boundary is violated or when we feel “out of place.” If someone constantly violates your boundaries, and you don’t notice, your skin will “notice.”

Headache and migraine

The body and mind, which have been tense for a long time, relax and “let go” of the pain. Migraines are often just a symptom that tells us we’ve taken on too much and haven’t managed it mentally. There are too many emotions “in our heads.” This is especially true for anger. Suppressed aggression often manifests itself in a “harmless” form as a migraine.

Palpitations, pressure, feeling of tightness in the chest

With a normal ECG, it’s often anxiety that has found a physical outlet. We often worry about trivial things. Anxiety never comes out of nowhere, but our expectations that trigger anxiety are often unfounded. It often helps to identify the non-existent source of anxiety in order to help ourselves.

Hormonal imbalances and menstrual cycle problems in women

Stress has a direct impact on the hormonal system. Menstrual irregularities or a sudden increase in PMS can also be a psychological signal. Here, too, we look for the source of stress. And most importantly, how we process it. It’s a mistake to think that stress can be eliminated. Life will continue to be a source of stress, but we can react to it differently.

Decreased immunity, frequent colds

“I caught a cold from stress” is not a folk myth, but a documented fact. Chronic tension inhibits the immune system. Let’s look at stress above.

“But the doctors found nothing” – what does this mean?

Many people hear doctors say, “We can’t find an organic cause.” They take this as “meaning I’m making it up” or “meaning there’s something wrong with me.” But that’s not what it means. It means the symptom is real—but its cause isn’t organic, but rather the functional state of the nervous system. The body does feel pain, fatigue, and spasms. It’s just that the source isn’t in the tissues or organs, but in how the nervous system processes stress and emotions.

Many of my clients talk about how many pills they’ve taken throughout their lives. But such symptoms can’t be cured with pills. Pills can relieve the symptom temporarily. But as long as the cause—psychological—is present, the symptom will return. Or a new one will appear. So, for years, people go to doctors, trying one thing, then another, then a third—and still can’t get better. Because the real doctor in this case is a psychotherapist.

Why does the body “choose” to be sick?

This is a question that many people have: why can’t we simply experience an emotion without physical symptoms? How are our emotions connected to the body? Or how is our psyche connected to the body? But what if I told you that our body is our psyche? Who told us that the psyche is only in the head?

Now imagine that the body simply reflects everything that’s happening in the psyche? Any emotion generated in the psyche is energy. Energy can either be processed (experienced, spoken about, expended), or it will find its own application. For example, if
a person is forbidden to be angry, they may develop chronic tension in the jaw or neck. If a person is forbidden to cry, they will feel stuffy or have a lump in the throat. If a person needs to “hold it all in,” hello back pain. The body is saying what the psyche cannot or does not dare say out loud.

Psychosomatics and war

I’d like to specifically discuss something that’s currently relevant for many of my clients. War, emigration, and chronic uncertainty—these are long-term stressors of the highest order. And the body reacts to them.
Research shows that psychosomatic symptoms increase sharply after traumatic events. People who have been evacuated, lost their homes or loved ones, and live in constant anxiety for those left behind often begin to experience illnesses they never had before.
The body “stores” trauma. It remembers it even when the mind tries to move on. If you experience unexplained physical symptoms after an experience, it’s not just your imagination. It’s your body asking for help.

What does psychosomatic therapy look like?

Psychosomatics is my specialty. And I want to be honest about what this work looks like.
We don’t “treat the symptom.” We look for what lies behind it.

• The first step is to listen to your body. Most people with psychosomatic disorders have learned to ignore their body’s signals. We begin by re-establishing this connection—noticing what’s happening physically and when.
• The second step is to find the emotion. Behind every symptom is a feeling that hasn’t found an outlet. Anger, fear, grief, shame, helplessness. We carefully seek out what’s there and give it space.
• The third step is to understand the context. When did it start? What was happening in life at that moment? What situations exacerbate the symptom, and which alleviate it? These answers provide a map.
• The fourth step is to change your attitude. Don’t “defeat” your body or ignore it. Instead, learn to hear and respond to its signals before they become a scream.
• It’s not a quick process. But these are real changes that won’t go back.

How do you know if your symptom might be psychosomatic?

There are a few signs to look out for:

• The symptom occurs or intensifies during moments of stress, conflict, or after emotionally difficult events.
• Doctors cannot find an organic cause or treatment does not produce lasting results.
• The symptom changes depending on your emotional state – better on vacation, worse at work
• Along with physical symptoms, there is anxiety, depression, or a feeling that “something is wrong.”
• There is a tradition in the family of “not talking about feelings” or “holding on”
• The symptom appears after a significant stressful event or trauma.
  If any of this resonates, it’s worth talking to a professional.

Frequently Asked Questions

Does “psychosomatics” mean I’m faking it? Absolutely not. Psychosomatic pain or symptom is just as real as any other. The difference is in the cause, not the “authenticity.” Your body is truly suffering. It’s just not organic.

Should I stop seeing a doctor? No. It’s important to first rule out organic causes—a doctor does that. But if doctors “find nothing” and symptoms persist, you should also consult a psychotherapist.

How long does psychosomatic therapy take? It depends on the severity and duration of the symptoms. Sometimes changes are noticeable after just a few months. Sometimes, more time is needed. However, most clients report an improvement in their well-being well before the end of therapy.

Is it possible to work online? Yes. I specialize in psychosomatics and work with clients online—it’s a full-time job.

Can a child have psychosomatic symptoms? Yes, children also have psychosomatic reactions. But I only work with adults.

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Your body is not your enemy. It’s your ally. A symptom isn’t a malfunction. It’s a signal. Your body’s attempt to tell you something important. The question isn’t “how to drown out the signal.” The question is “what is it trying to tell me?”
I help people hear this and respond. Not through willpower or more tests. But through genuine engagement with what’s inside. If you recognize yourself in this article, let us know. We’ll figure it out together:

Read also
Apathy and “I don’t want anything” are another form of the body and psyche saying “stop.”
Imposter syndrome – chronic stress from “keeping up a mask” leads to psychosomatic symptoms.
Psychologist for Ukrainians in exile – the stress of emigration and the body.

This article was written by Natasha Kokhan, a practicing Gestalt psychotherapist with experience in psychosomatics. This material is for informational purposes only and does not replace medical advice.