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Do you often struggle with headaches or other symptoms that may have a psychological basis? Perhaps what you are experiencing is somatic anxiety.

The term „neurosis” or somatic neurosis has become firmly entrenched in everyday language. Moreover, it affects the imagination. For some, it is associated with a nervous, irritable person, while for others, it is someone lost in thought, constantly absent-minded and fearful. Due to the stereotypes or profiles drawn in popular culture, it is not easy for a person struggling with neurotic disorders to recognize the importance of the difficulties experienced. However, the suffering often impairs daily functioning and becomes a persistent problem that should not be trivialized.

Symptoms of neurosis.

The symptoms of neurosis vary depending on the type of neurotic disorder that the person is struggling with. They can generally be described in terms of somatic (e.g. tension headaches), emotional (e.g. phobia), and/or cognitive (e.g. difficulties in concentration) categories. In order to talk about neurosis, the symptoms cannot be explained by situational (e.g. exam), physical (e.g. poisoning), or somatic illnesses. In neurosis, the presented symptom is a result of emotional conflict. Often, the person is not aware of its existence and only feels unpleasant discomfort such as anxiety or fear. Anxiety is an interesting phenomenon – unlike fear, it does not have a concrete, easily perceptible, objective source. Freud believed that the source of neurotic anxiety (signal anxiety) should be sought in the „defective” operation of the repression mechanism, which causes certain impulses (e.g. stressful thoughts, memories) to begin to reach consciousness. They are unwanted, difficult, or unacceptable for various reasons. The „idea of neurosis” is to create a certain symptom (e.g. headache) that temporarily neutralizes the unpleasant anxiety [2]. The occurrence of the symptom reduces the felt discomfort and also creates the possibility of avoiding the situation associated with the source of anxiety. However, it causes additional difficulties and does not solve the problem’s underlying cause. Often, the person seeking help complains about the occurrence of a specific symptom and is only interested in getting rid of the observable difficulty. It happens that the presented symptoms are so strong that the support of pharmacotherapy is beneficial. However, neurotic disorders cannot be reduced solely to pharmacological intervention.

What is a somatic neurosis?

In the medical classification ICD-10, anxiety disorders are referred to as anxiety-related disorders with somatic expressions (F40-F.48). This category includes various types of disorders differentiated based on their characteristic features. It comprises phobic anxiety disorders, other anxiety disorders, obsessive-compulsive disorders, reactions to severe stress and adjustment disorders, dissociative disorders, disorders presented under the guise of somatic symptoms, and other anxiety disorders. These disorders contain subtypes that allow for a more thorough understanding of the difficulties reported by the individual. Each type of disorder manifests in a unique way, enabling differentiation of the specific difficulties and adaptation of the appropriate form of support [3]. However, it is rare for a disorder to progress homogeneously, and mixed anxiety symptoms with varying intensity are more frequently observed in individual patients [1]. Diagnosing anxiety disorders presented under the guise of somatic symptoms (somatic symptom disorder, undifferentiated somatoform disorder, hypochondriacal disorder, autonomic dysfunction presented as somatic symptoms, persistent psychogenic pain, and others) appears to be particularly challenging [3]. It requires the exclusion of organic causes, leading to the necessity of conducting a series of medical examinations by various specialists, which often raise additional questions and do not provide clear answers. Individuals suffering from disorders presented under the guise of somatic symptoms continuously complain of the symptoms and seek medical help, even though the symptoms cannot be explained by physiological disorders or somatic diseases.


In practice, a person who presents with symptoms such as a headache should rule out any possible medical causes before visiting a psychotherapist. In the case of migraines, a consultation with a neurologist is necessary. Migraine is a chronic neurological disorder that is genetically determined. In addition to severe headaches, nausea and increased sensitivity to external stimuli are usually present. Studies indicate that it results from excessive reactivity of the central nervous system. Migraines are often triggered by common causes such as menstruation, ovulation, an unhealthy lifestyle, or stress. People suffering from migraines are sensitive to environmental stimuli such as smells and light. The situation is different in the case of neurotic headaches. The „trigger” of the symptom is usually an emotional conflict that can intensify in the face of specific psychosocial demands or problems. Nevertheless, in both cases, the person suffering from the symptom seeks a medical cause. It can happen that the patient’s immediate surroundings are tired and irritated by the constant search for the cause of the discomfort. However, more often, the person struggling with the disorder receives attention and special care from their family. It is a specific situation in which attention and care are gained due to suffering, which can be an obstacle to the healing process.

The occurrence of neurosis can be seen as a hindrance to daily functioning, but according to Dąbrowski’s theory, it also provides an opportunity for comprehensive and multi-level development. In this context, the emergence and resolution of conflicts create an opportunity for an improvement in the quality of life. However, in cases where the symptoms persist, it is worth consulting a psychiatrist or a psychotherapist.

  1. Kępiński A. Psychopatologia nerwic. Wydawnictwo Lekarskie PZWL , 1986

  2. LeDoux J. Lęk. Neuronauka na tropie źródeł lęku i strachu. Copernicus Center Press, Kraków 2017

  3. Międzynarodowa statystyczna klasyfikacja chorób i problemów zdrowotnych. Klasyfikacja Zaburzeń psychicznych i zaburzeń zachowania w ICD-10. Uniwersyteckie wydawnictwo medyczne „Vesalius”, Kraków-Warszawa 2000.

  4. Linde M., Migrena: współczesne kierunki leczenia, przedruk za zgodą z: Acta Neurologica Scandinavica 2006; 114: 71–83

  5. Nitsch K., Jabłoński M, Samochowiec J., Kurpisz J. Zaburzenia pod postacią somatyczną: problematyczne zjawisko — problematyczna diagnoza, Psychiatria 2015; 12, 2: 77–84

  6. Dąbrowski K., Dezintegracja pozytywna, Państwowy Instytut Wydawniczy, Warszawa 1979

mgr Magdalena Palonek
Psycholog i psychoterapeutka specjalizująca się w prowadzeniu psychoterapii indywidualnej osób dorosłych, dzieci i młodzieży. Czytaj więcej

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