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Pain That Carries Meaning: Decoding Psychosomatic Signals
Bodily symptoms – messages from the unconscious to the conscious mind
More and more people experience sensations in their body that doctors cannot explain through physiology alone: chest tightness, stomach aches, headaches, skin reactions. This does not mean that the symptoms are "in our heads." It means that the body participates actively in how we process our emotions.
Psychosomatics explores precisely this connection – what happens when the psyche cannot bear the tension and it crosses over into the body. Bodily symptoms are a message from the unconscious to the conscious mind; they tell us that some experience was once missed or left unprocessed (Peseschkian, 2003).
When Words Are Absent
Generally speaking, bodily symptoms appear where words are absent. When a person cannot name their emotion or turn it into a thought, the body becomes the only "speaker." Instead of "I am angry," a tightness appears in the stomach. Instead of "I am afraid," back pain arrives. This is the psyche's way of surviving when there is no other means of coping (The Global Psychotherapist).
Bion answers this question through projective identification: the infant projects (projection is a defence mechanism in which we unconsciously attribute our own emotions to others, rather than recognising them as our own, with the aim of reducing internal tension) feelings that cannot yet be understood or expressed in words onto the mother. If she is "good enough," she can contain (a term introduced by D. Winnicott, describing how the mother or primary caregiver creates psychological and emotional safety for the infant), modify, and return these projections in such a way that they become tolerable to the child's psyche (Bion, 1962). If this does not happen, the emotions remain "locked" in the psyche or manifest in the body as symptoms – such as bodily pain, skin reactions, or chronic fatigue. In many cases they are linked to unprocessed anxiety and intense emotional tension (Bion, 1961; Bronstein, 2010).
Common Psychosomatic "Signals"
The stomach – often reacts to unrecognised anger and tension.
The skin – reflects a sense of lack of protection or safe closeness.
Headaches – sometimes accompany suppressed guilt, self-blame, or excessive control.
Palpitations – arise when fear has no name.
In other words, psychosomatic symptoms often carry hidden meaning – they are a reflection of experiences and emotions that were never contained and modified during early development.
The Hidden Meaning of the Symptom
The symptom has a dual function:
Regulatory function – the body allows the psyche to "evacuate" inexpressible emotions that might be destructive if they remained only in the mind.
Semiotic function – the symptom is a signal of an inner conflict or traumatic experience that the body conveys to the outside world and to the individual themselves.
In Peseschkian's words, the symptom is not only a sign of inner distress but also an invitation to pay attention to experiences that have been excluded from consciousness.
The pain or skin reaction is not merely coincidental, but a carrier of psychic content that awaits recognition and integration.
Clinical Examples
A man with chronic colitis – he never expressed anger or tension; his body "speaks" in his place.
A woman with atopic dermatitis – symptoms appear during marital conflicts; the skin "conveys" a sense of vulnerability and lack of protection.
A teenage girl with headaches – she experiences frustration and fear of failure, which manifest physically.
How Therapy Helps
The therapeutic process creates a space for containment, understanding, and symbolisation of experiences:
Creating a safe space where the patient can express what is unconscious.
Transforming unrecognised emotions into thoughts and symbols.
Connecting bodily reactions to the inner world and turning them into meaning.
In this way, the symptom begins to be "heard" not as a signal of danger, but as an invitation towards the integration of psyche and body.
"Bodily symptoms are not a whim but a message – they tell us that there was once no one to contain our emotions, or there was, but they did not know how" (The Global Psychotherapist).
When this changes, the body gradually stops "screaming" – because there is now someone to listen.
References
Freud, A. (2000). The Ego and the Mechanisms of Defence. Sofia: Lik.
Wilfred Bion. (1962). Learning from experience. London, UK: Heinemann.
Bion, W. R. (2023). Second Thoughts. Sofia: Riva.
Winnicott, D. (2008). From Paediatrics to Psycho-Analysis (translated into Bulgarian). Sofia: Centre for Psychosocial Support.
Catalina Bronstein. (2010). On psychosomatics: The body as a target of primitive attacks. International Journal of Psychoanalysis, 91(5), 1077–1095.
Peseschkian, N. (2003). Psychosomatics and Positive Psychotherapy – Volume 2. Varna: Slavena.
The Global Psychotherapist. (n.d.). Articles on psychosomatics and positive psychotherapy. Retrieved from https://www.positum.org