introduction

There is pain that cannot be entirely attributed to organic causes. Often this pain is mistakenly dismissed as pure "imagination".
If people experience physical symptoms that cannot be explained even after extensive diagnosis, this is called a somatic disorder.
Diseases of this nature have been officially recognized since 1980 and require psychosomatic evaluation and therapy.
In addition to pain, there are a number of other symptoms, such as nausea, dizziness, a feeling of pressure in the chest, high blood pressure, which can occur as part of a somatic disorder. The underlying causes can be very different here.

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Why can you feel pain that cannot be assigned to any disease?

In recent years medicine has moved away from the original assumption that pain is always caused by tissue damage. The new definition of pain clearly emphasizes the psychological-emotional aspects of pain development and emphasizes that pain is a purely subjective feeling.
So the feeling of pain can also be a product of our psyche, which arises in our thoughts, but can be perceived in other places in our body.

Such somatoform pain can be triggered by many factors in our life.
For example, depression is in many cases associated with the development of somatic pain or other somatic disorders. The exact origin of this form of pain has not yet been clarified in detail.

In the case of certain disorders, however, it is assumed that in childhood there are links between physical pain experiences and certain behavioral patterns that later play a major role in pain perception and can thus lead to somatic pain.

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Read more on the topic: Depression: these are the signs

causes

Pain imagination and hypochondria

Under the umbrella term hypochondria, various clinical pictures are summarized, ranging from a pronounced health behavior and awareness to the so-called hypochondriac delusion.
Hypochondria is often based on a pronounced fear of illness or being ill.
Since these patients usually have a heightened conscious body awareness, they quickly attribute many normal perceptions, such as a slightly increased heart rate, to an illness.

A hypochondriac disorder, depending on its extent, can have a major impact on the quality of life of those affected, as they deal excessively with diseases and very often go to a doctor to rule out possible diseases.
As a result, the topic of illness can overshadow their entire everyday life and social interactions are neglected.
If a person is suspected of having hypochondria, it is advisable to talk to a psychotherapist first. Treatment usually consists of cognitive behavioral therapy.

More information on this topic: Psychosomatics - when the psyche causes physical complaints

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Psychosomatic pain

Psychosomatic illnesses are complaints that are caused by psychological stress or factors and that have a significant influence on the quality of life of those affected. Most psychosomatic disorders are the expression of unprocessed emotional pain or other life experiences that can be traced back to profound life events. Such can be, for example, the loss of a loved one or disregard.

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In most cases, psychosomatic pain is chronic pain and is usually a diagnosis of exclusion in the diagnosis, which means that all other possible causes of chronic pain are ruled out first.
Therapy for psychosomatic pain usually consists of psychotherapy, the aim of which is to identify and reduce the underlying internal conflict. In addition to this, other therapy options such as relaxation techniques, exercise, occupational therapy and social therapy are recommended.

Also read the article on the topic: Psychosomatic back pain

Phantom pain

Phantom pain is the perception of pain in an amputated part of the body.
This means that people who have had an arm amputated, for example, feel pain in the original location of the arm. The perception of pain is the pure product of the psyche.

A distinction must be made between phantom pain and stump pain, which corresponds to the development of pain in the permanent stump. The phenomenon of the phantom sensation in an amputated limb is common, but it does not always have to be a pain sensation, but is also often described as pure tingling or itching.
The exact cause of phantom pain has not yet been adequately clarified, but an overreaction of the sensitive cerebral cortex is suspected, which is caused by the lack of sensory information. The treatment of this clinical picture consists on the one hand of drug therapy with antidepressants. But other therapy options such as biofeedback or so-called mirror therapy are also gaining increasing popularity.
In mirror therapy, the image of the healthy half of the body is projected onto the sick side of the patient by means of a mirror in the middle between the two limbs. This visual stimulus evokes memories of the former part of the body in the brain. This triggers reactions that suppress phantom pain.

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You may also be interested in this topic: Amputation - You Must Know That

Imagination of pain through fear

As described in more detail above, we now know that pain perception is not always due to tissue damage, but can also be caused by psychological triggers. This phenomenon can also be observed in emotional stressful situations, such as feeling fear.

The relationship between pain and anxiety in most patients is based on a pronounced fear of feeling pain or that existing pain might get worse. As a result, these people develop an increased awareness of pain, which in many cases leads to an intensification of the pain.
Another possible explanation for this phenomenon is that fear is a signal for humans that is supposed to protect us from the dangers that might come with the development of pain.
If this development of fear is now strongly pronounced, it can happen that one already feels it just through the expectation of coming pain.

Imagination of pain in depression

Many recent studies have shown that there is a clear correlation between the perception of pain and the existence of depression. The exact cause of this connection is not yet understood.
The interplay between somatic pain and depression can come from either direction. An existing depression can lead to increased pain perception.

Conversely, chronic pain, even if it is somatic, can also lead to depression.
In the treatment of these cases, in which there is depression and somatic pain, it has been shown that both diseases must be treated in order to achieve therapeutic success.

More information on this topic: Depression - What To Do?

What can you do if you imagine pain?

Since the cause of an “imagined” pain is assumed to be in the mental area, a possible therapy should also start here.
Psychotherapy is therefore the recommended therapy for psychosomatic pain. Such a therapy works with many different methods and the focus is mostly on dealing with internal conflicts and emotions that lead to the perception of pain.
However, the current therapy concept for somatic disorders also includes other approaches such as group therapy, occupational therapy, exercise therapy and the practice of relaxation techniques.

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In some cases, however, psychotropic drugs, such as antidepressants, must be used in order to improve the success of the therapy or even make it possible in the first place.

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