The conversion
of conflicts in the unconscious mind into physical symptoms of illness is one of the most commonly employed of all mental
mechanisms. Physicians estimate that at least half the patients they see are
suffering from complaints in which psychic or emotional factors are the prime
if not the sole complaint.
The student who always gets
a headache when faced with an examination is displaying a conversion symptom-
So, too, is the soldier who suffers from hysterical blindness when he sees his
buddy blown up a few feet away from him. Conversion reactions are in fact more
common in wartime than peacetime, and they are the explanation of such conditions
as hysterical paralysis, convulsions, loss of voice, deafness,
''shellshock," "soldier's heart," and "battle
fatigue."
Illness becomes a way out
of an intolerable situation. Physical pain is substituted for inner anxiety.
The patient is unaware of the source of his pain. It is just as real to him as
if it had a definite basis in a recognizable bodily defect. For example, a
patient with a severe backache of purely psychogenic orign feels just as bad as
if X-ray evidence actually showed a fracture in his spine.
Conversion symptoms are
often difficult to relieve for the added reason that they offer some secondary
gains or benefits to the patient. He gets sympathy because he is
"sick"; he may be relieved from the pressure of ordinary duties and
responsibilities; he may even collect unearned money because of his
"affliction." For example, some people who have been involved in
accidents do not recover from their symptoms until they receive a substantial
cash settlement from an insurance company.
The "chronic
invalid," the hypochondriac always worried about his health, and the
neurotic who "enjoys" poor health offer further examples of
conversion reactions. There is no accounting for their long lists of vague
aches, pains, and other complaints except on a psychological basis. Fatigue is
one of the commonest complaints.
Nevertheless
actual impairment of bodily functions may result from prolonged unconscious
conflicts. Practically any organ or system
of the body can be affected by "psychophysiological
disorders." Many emotional reactions, for example, are visibly expressed
in skin troubles. Other diseases which may be initiated or aggravated by unconscious
anxiety include bronchial asthma, peptic ulcer, chronic colitis, and heart disease
(especially disease of the coronary arteries). Bodily illnesses wholly or
partly of psychic origin are often described as "psychosomatic" —from pysche,
for mind, and soma, for
body.
