Many terms have been popularized over the decades to denote illnesses that appear to have their causal origins not in identifiable physical ailments, but in overwhelmingly painful emotions or unmanageable stress. Terms such as psychosomatic, somatoform, psychophysiological, functional, and others have been employed to describe illness for which there is no identified physical cause.
The term "stress illness" is used by David C. Clarke, M.D., a gastroenterologist, who practices mind-body medicine and has written extensively on his methodology and understanding of physical manifestations of discarded and repressed painful emotions. In his book They Can't Find Anything Wrong, he presents many case examples of people who recovered from disabling physical disorders for which modern medical diagnostic procedures rendered no positive findings.
Clarke's categories of causal stress factors are extremely useful. They include:
Clarke emphasizes the healing power of a clinician deeply listening to the patient; this provides clues to the category of stress, as well as the specific incidents that caused the brain to translate painful emotions into the language of the body that take the form of pain and physical symptoms.
A large proportion of conditions that cause people to seek medical attention fall into the category of the unknown. Traditional medical education has by and large neglected to teach diagnostic and treatment approaches to help people identify and overcome physical illnesses that may be caused by stress. Fortunately, there are growing professional healthcare movements to correct this costly oversight.
How Patients Can Cope
In my own clinical practice, I see many patients recovering from serious auto accidents who present with combinations of all five of Clarke’s causal stress types. It typically requires a great deal of courage for both patient and clinician to confront repressed emotions and overwhelming current stressors, but the benefits clear the way for lasting healing.
A crucial part of the recovery process is learning self-care. Unfortunately, for many who survived dysfunctional family life in their formative years, self-care can be an unfamiliar skill.
Another vital skill is learning how to elicit the relaxation response and experiencing the feeling of safety. For individuals who survived childhood traumas—such as witnessing violence or being sexually abused—feeling safe can be an unfamiliar experience. Clinicians who are trauma-informed and stress illness-informed are in a key position to guide the patients lost in the medical and disability systems to a place of healing and posttraumatic growth.
Utilizing tools like EMDR and sensory-motor psychotherapy in my clinical practice, I am often amazed at how the language of the body is sensation, and how responsive the body is to speak its language when invited to do so. Trauma truly is registered in the body—and when the verbal and analytic resources of the brain are engaged toward physical sensations, a somatic permissive environment for healing can be created for many people. I’m pleased to see that there is a growing literature to guide professionals in mind-body medicine as it signifies there is hope for people who suffer from physical conditions for which there are no identified medical or structural causes.
Suggested Reading and Resources
David D. Clarke, MD (2007). They Can't Find Anything Wrong: 7 Keys to Understanding, Treating and Healing Stress Illness. Boulder, CO: Sentient Publications.
James F. Zender, PhD (2020). Recovering from Your Car Accident: The Complete Guide to Reclaiming Your Life. New York: Rowman & Littlefield.