Psychological trauma and somatization processes: a complex relationship.

The mentalizing processes allow a psychological representation and control of emotions (including related somatic states) and are fundamental for psycho-physiological regulation and for stress management. In all the life difficulties which may interfere with individual development assuming a traumatic value (illness, losses, family conflicts, splitting and divorces, neglect, abuses, dangerous physical experiences, social exclusion, serious economic problems) reflective functions tend to be impaired. In these cases, the representation of the individual self tends to be only somatic and the physiological reaction to stress is out of control. Research has shown that in these individuals somatic symptoms and abnormal illness behavior (hypochondriacal concerns, somatization disorders, functional medical syndromes) can appear, as well as an increased susceptibility to physical or mental illnesses. From the psychological point of view, in fact, these conditions are often characterized by a lack of impulse control (violent or aggressive behavior, panic attacks, fugues, antisocial behavior) or dissociative disorders (amnesia, fugues, depersonalization), expressions of an attempt to protect against traumatic consequences of mental tension. Moreover, subjects with reflexive difficulties tend to manifest compulsive and increasingly extreme behavior (smoking, drinking, taking drugs, eating too much or too little, driving too fast, extreme sports or sexual activities, gambling, excessive use of chat, video games and internet) in an attempt to regulate and control the disturbing emotions in a non-psychological way. The tendency to use these "external regulators of emotions" involves a greater vulnerability to psychic and somatic effects of traumatic experiences and is a feature of many medical illnesses and psychiatric disorders, particularly borderline personality disorders, eating disorder and addictions.