Backwards and in feels

Somaticization is the tendency to experience mental distress as physical distress. For instance, some people with depression don’t report low mood, but instead things like nausea or pain.

A 3-stage model of emotions mediated by somatic responses would explain this fairly well. In most people, the cognitive processes that generate emotions do not directly generate qualia, but only affect our physical and mental behavior. These in turn are read by other mental processes that summarize them into feelings. Somaticizers, by this model, are people who are acutely consciously aware of the intermediate somatic stage of their feelings, but for whom the summarizing processes are either suppressed or weak to begin with.

In talking with friends about their experiences, I’ve noticed that this process can run in reverse as well - physical ailments with non-mental origins can get picked up by processes that are looking for somatic symptoms of emotions:

Emotions with reverse somaticization

For example, one friend reported that they never got headaches, and separately that they often felt an intense sense of sinfulness. For unrelated reasons, at one point I happened to give them a scalp massage - and their sense of being sinful went away. They then recalled that their pervasive sense of sinfulness might have roughly coincided in time with a point at which they decided that they shouldn’t get headaches - and, as far as they could tell at the time, stopped. But it hadn't stopped - it had just been reinterpreted as the feeling of guilt.

On occasion, I’ll feel lonely, but like there’s no social contact that would fix it. If I eat fatty red meat, or take B vitamin complex sublingually, then I typically feel better almost immediately. However, on at least one occasion, this didn’t work. Lying on my bed, sad and low-energy, I tried to get a narrative out of myself for what was wrong. My brain responded that I was sad because I didn’t have any strong allies that would take initiative to further my interests. But I also noticed that the surface-level tingling I’d noticed since the Vipassana retreat was especially strong. So I took up my Theracane and gave myself a massage - and the loneliness was diminished and I could get things done.

I’m not sure which direction the somaticization went - whether I somaticize wanting higher-quality relationships as physical discomfort, or whether I reverse-somaticize wanting a vigorous massage as wanting a powerful ally. In any case, the metaphor is apt - a powerful ally is one both willing and able to muster a strong force to help me.

Katja reports something similar:

Sometimes I feel like everything is terrible for five minutes or so before figuring out that the problem is that I’m in physical pain. I even explicitly wonder whether the problem is pain, and decide probably not, before later realizing I was wrong.

The standard way to use knowledge of somaticization is to resolve that if you notice yourself, or someone else, exhibit somatic distress, and you’ve ruled out likely physical causes, you should consider mental ones. But you should also do the opposite: if you or someone you know is experiencing apparently causeless mental distress, you should consider that there might be a simple physical cause. They might have a nutritional deficiency - or, they might be in chronic pain.

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