Somatization in Social and Cultural Perspective : From research to clinical strategies

Abstract

Somatization refers to a process of expressing emotional or psychological distress through somatic symptoms. In psychiatric nosology, the somatoform disorders are characterized by medically unexplained somatic symptoms and may include many patients with functional somatic syndromes due to physiological disturbances. The cross-cultural applicability of the concept of somatization and its relationship to mood and anxiety disorders are discussed. In many cases somatic symptoms form parts of cultural "idioms of distress" ordinary ways of talking about the body and social problems that may not be pathological. When somatic symptoms intensify and persist, however, they become problems in their own right. An integrative model of persistent somatization is outlined in which constitutional, cognitive and social factors amplify bodily distress and lead to help-seeking and disability. Symptom attributions which are influenced by cognitive style, previous illness experience and cultural models of illness behavior and disease have been shown to contribute to somatization. Viewed in social and cultural context, somatic symptoms have multiple levels of potential meaning. This sociocultural perspective leads to innovative clinical strategies for alleviating somatic distress.