I had always considered that psychosomatic reactions, such as Psychogenic pain, while "real" to the person experiencing them, would be a concious reaction at some level. That is to say, if the person told themselves "this isn't real" - they would be able to tell that the reaction was "in their head".

However, after some recent research on Couvade Syndrome I became curious if a person could have completely unconscious physchosomatic reactions that they could not suppress with "will". Assume in this case we're talking about an otherwise mentally healthy individual who isn't hearing voices or anything like that.

  • $\begingroup$ Well look who popped up on Cog Sci :) $\endgroup$ – Ben Brocka Jul 12 '12 at 14:27

Good question and this is very big topic mate. Short answer is - every psychosomatic disorder is unconscious in the sense that it's coming from psychological tension but reflects itself in some unpleasant somatic/bodily reaction (e.g. headache, lower back pain, high blood pressure). In general, even if you are conscious of the source of psychosomatic reaction (e.g. stressful job causing evening headaches) you can't really talk yourself out of it. But you still can make some short term changes (pop a pill) or long term changes that (quit a job, meditate) to reduce the psychosomatic effects (Grossman et al., 2004).

Grossman, P., Niemann, L., Schmidt, S., Walach, H. (2004) Mindfulness-based stress reduction and health benefits - A meta-analysis. JOURNAL OF PSYCHOSOMATIC RESEARCH, 57 (1): 35-43

But it's probably not that simple. While we can say that psychosomatic disorders are by default unconscious, we need to consider wider range of factors that causes them and ask more questions.

One such question is why people get psychosomatic disorders? Stress is the best, most popular, most studied, most quoted, and most mysterious, simple, single answer to this question. Ulcers, asthma, chronic fatigue syndrome, rheumatoid arthritis - you name it. In general terms, increase in cortisol due to stress punches holes in your body, although the lack of cortisol has been argued to have impact too (Heim et al. 2000).

Heim, C., Ehlert, U., Hellhammer, DH., (2000) The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. PSYCHONEUROENDOCRINOLOGY, 25 (1): 1-35.

But you see, the longer I think about it, the more complicated it becomes. So I stop here.

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  • $\begingroup$ Persistent lack of cortisol due to stress By and large, stress increases cortisol dramatically. I think that article was stating that under certain conditions of stress, the opposite is true, which can be just as detrimental. This is more the exception, not the rule, it seems. $\endgroup$ – Chuck Sherrington Jul 13 '12 at 1:31
  • $\begingroup$ @ChuckSherrington: Indeed, my bad, correcting immediately, thank you for pointing out this error. $\endgroup$ – Geek On Acid Jul 13 '12 at 13:05
  • $\begingroup$ It's all good, it's the way it was written in that paper (which sounds interesting, so glad you included it) that was a bit confusing. $\endgroup$ – Chuck Sherrington Jul 13 '12 at 14:54
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    $\begingroup$ Fatigued breast cancer patients are one population who have been studied and found to have a lack of cortisol. If you expose them to a stressor, they appear unable to mount the typical cortisol response, despite reporting high levels of stress. The distinction is tricky because their cortisol slopes may appear similar to a healthy person who simply does not find an event stressful (I'm thinking primarily of the Trier Social Stress Test experimental paradigm by Kirschbaum, but there are others). I believe hypo basal cortisol levels are rare (diurnal rhythm may atypical though). $\endgroup$ – Joshua Jul 14 '12 at 14:39

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