Psychosomatics and Central Sensitization in Early Development

In the area of psychogenic functional psychosomatic disorders there has been a gradual change in the view of the so called absence of positive somatic findings. The application of imaging methods in [the] brain research indicates that the brain processes in patients with so called functional disorders have certain neurological peculiarities. Some authors designate these as central and peripheral sensitization, or simply as the domination of the subcortex, mainly the diencephalon, in the processing of stress arousing external and internal stimulation. These phenomena indicate a dimished capacity to symbolize and mentalize due to the inability of the cortex to process incoming stimulation. Rational and emotional experiences are replaced by somatization with the help of the so called low “dirty” road” located in the subcortex. This road can be reinforced in early childhood (attachment period) due to repeated traumatic experiences caused by a non-empathic (maternal) environment or the lack of the maternal physical or psychic presence. This leads to insufficient development of the brain roads leading from the thalamus to the developing cortex (high road), and thus the child remains much more dependent on the somatic processing of the stress arousing stimulation.

Child and adult psychotherapy attempts to strengthen symbolization and mentalization, in terms of the brain processes this means stimulating better functioning of the high road directed from the thalamus to the cortex area. It can also help to [some improve the regulation of lower brain process whose task it is to manage a proper functioning of the somatic systems.

The convergence of psychoanalytic theories with neuroscientific discoveries has a very promising future that Freud had envisioned. In psychotherapy of psychosomatic disorders we attempt to find a connection between the somatic symptom and the patient's imaginary and symbolic mental level which was lost or must be discovered anew.