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Medically Unexplained
Physical Symptoms

  • ­Have you been suffering from physical symptoms for which there seem to be no effective treatments?

  • Have you seen multiple specialists without any conclusive findings?

  • Are you experiencing emotional stress that might be contributing to your medical symptoms?

If the answer to any of these questions is “yes,” I may be able to help. I specialize in treating Medically Unexplained Physical Symptoms (MUPS).


It’s well known that physical symptoms can result from unconscious emotional conflict. The emotional center of the brain is intricately connected with important structures and systems within the body — the skeletal system, the voluntary muscles that control movement, and involuntary muscles such as the smooth muscles that line the stomach, bronchi, and urogenital center. The fight-or-flight reaction, so essential to our survival, depends on these interconnections. But these same connections can convert the anxiety generated from our emotional reactions into many different physical symptoms that cannot be explained by medical examination. The conversion of emotional conflict into physical symptoms is called somatization. In the medical field these disorders are referred to as Medically Unexplained Physical Symptoms (MUPS).

Some of the most common MUPS include:

  • back pain

  • fibromyalgia

  • Irritable Bowel Syndrome (IBS) or functional dyspepsia

  • migraine and tension headaches

  • hypertension

  • neurological symptoms (e.g., blurry vision, dizziness, tingling or numbness in arms and legs)

  • rashes or itching

  • Erectile Dysfunction (ED)

  • pelvic pain, Urethral Syndrome

  • Chronic Fatigue Syndrome

  • Tension Myositis Syndrome (TMS)

  • Complex Regional Pain Syndrome (CRPS)

Continued —


[¹] Abbass, A. Kisely, & Kroenke, K. (2009). Short-term Psychodynamic Psychotherapy for Somatic Disorders: Systematic review and meta-analysis of clinical trials. Psychotherapy and Psychodynamics, 78, 265–274.

[²] Abbass, A. (2005). Somatization: Diagnosing it sooner through emotion-focused interviewing. The Journal of Family Practice, 54, 215–221.

[³] See more research on somatic disorders at The Center for Emotions and Health, Dalhousie University Web site.

For more information about medically unexplained physical symptoms and their treatment, see:

Sarno, J. (2007). The Divided Mind: The Epidemic of Mindbody Disorders. New York: Harper.

Without psychological intervention, many patients suffer for years with physical symptoms, resulting in unnecessary medications, tests, operations, and hospitalizations.

Almost everyone has experienced somatization at some point in life. If you have ever become nauseous from anxiety or gotten a headache from stress, you have experienced somatization. When these reactions are isolated and infrequent, it is usually not a cause for concern. However, if you chronically convert emotions and anxiety into physical symptoms, it can cripple your ability to enjoy life. Naturally, when this occurs people seek medical attention. Half of all primary care visits are related to somatic complaints; and one-third to one-half of these patients leave their doctors’ offices with no medical explanation for their symptoms.[¹] Even worse, many patients feel dismissed, or are even told “it’s all in your head.” Not knowing what is causing the symptoms or having them dismissed as imaginary can create additional stress.
In treating MUPS, it is essential for psychologists and primary care physicians to work together, both to rule out underlying medical issues that could cause physical symptoms and to evaluate the possibility that a patient is experiencing MUPS. Fortunately, today’s medical practitioners are moving away from the view that somatic disorders are incurable conditions for which they can offer only support and solace. Research over the past 30 years on the effectiveness of psychotherapy for somatic disorders has brought new attention to the interplay between mind and body, and particularly the effects of unconscious emotions on somatic conditions. As a result, we know a lot more today about how emotional conflict translates into physical symptoms.
We know, for example, that many people with somatic disorders have been traumatized or mistreated by someone close to them. Feelings of anger toward the abuser, often unconscious, can create emotional conflict that leads to anxiety. Individuals then develop defense mechanisms to ease these feelings, or put them out of awareness. The internalization of anger appears to be a common thread in many somatization disorders, including IBS, hypertension, fibromyalgia, and migraine headaches. Similarly, blocking other emotions, such as sadness and grief, can also cause somatic symptoms.
Since the 1980s, many research studies have documented the effectiveness of Intensive Short-term Dynamic Psychotherapy (ISTDP) for treatment of somatic disorders.[¹][²][³]  Because the emotional conflicts that contribute to somatic disorders are usually out of the individual’s conscious awareness, ISTDP’s focus on bringing unconscious emotional conflict into awareness and working through underlying conflicts may be why this approach has proved so effective with somatic disorders.

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