This means that the body (“soma”) reacts with physical symptoms due to a psychological cause. It used to be called “psychosomatic”. Patients may be casually dismissed as “hypochondriacs” by their friends (and medical providers), but that’s inappropriate. It’s a rather severe form of Anxiety, with or without Depression. Here are some examples:
1. A 50-year-old woman had unusual body pains. They didn’t fit a pattern of any disease, her physical exam and lab tests were normal. I inquired about stress in her life, she denied any. A good friend who was with her confirmed that my patient was always calm, and there weren’t any issues at all.
I asked the friend to leave the room. Then I barely began to explain how stress can cause physical symptoms, “For example, if a person had been previously abused…” I never got to finish, tears streamed down the patient’s face. She began speaking fast, non-stop, about how as a teen “my best friend sold me…” Fortunately we had a therapist available on-site.
2. An excellent pediatrician I once worked with had a 10-year-old patient with chronic abdominal pain. All exams and tests were normal. The most likely reason was psychological, but the boy’s father was irritated, impatient for a physical diagnosis. My pediatrician friend told me, “The father, he looked, maybe, like an alcoholic? So I said, ‘For example, let’s say somebody at home is drinking all day…,’ and Dad’s eyes dropped immediately to the floor.”