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Trauma contributes to psychosomatic symptoms through several mechanisms:
Unprocessed Trauma:
Traumatic experiences that are not emotionally or cognitively processed can manifest as physical symptoms. The body may express what the mind cannot, leading to symptoms like headaches, pseudo-seizures, and other somatic complaints.
Symbolic Representation:
Physical symptoms can symbolize aspects of the traumatic experience. For instance, headaches might represent mental "holes" or gaps in the narrative caused by trauma, as seen in the case of Mohamed, whose headaches were linked to his father's death.
Failure of Symbolic Integration:
Trauma can prevent experiences from being integrated into the symbolic world of language and narrative. This leads to a "hole" in the psyche where the trauma is felt bodily rather than being represented mentally.
Impact on Internal Regulation:
Trauma affects the individual's ability to regulate emotions and bodily states. This dysregulation can lead to psychosomatic symptoms as the body attempts to manage overwhelming experiences. For example, Gloria's seizures were linked to her inability to regulate her emotional and physiological states.
Early Relational Trauma:
Early relational trauma, such as inadequate caregiving, can disrupt the development of an integrated sense of self. This can result in psychosomatic symptoms as the body attempts to draw the psyche back into itself. The lack of a "good enough" mother can lead to a failure in developing a cohesive self, manifesting in physical symptoms.
Intergenerational Transmission:
Trauma can have intergenerational effects, where unresolved trauma in parents manifests as physical symptoms in their children. This is often due to the parents' inability to contain and process their own and their children's anxieties, leading to symptoms like vomiting or food refusal in children.
Neurobiological Impact:
Trauma can cause changes in brain structures like the amygdala and hippocampus, affecting memory and emotional regulation. This can lead to a predominance of procedural over declarative memory systems, where traumatic experiences are lived more bodily and less attached to a coherent narrative.
In summary, trauma contributes to psychosomatic symptoms by disrupting the integration of traumatic experiences into the symbolic and emotional realms, leading to bodily expressions of unprocessed distress.
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