Characteristics of Somatic Symptom Disorder Somatic symptom disorder (SSD) is characterized by somatic symptoms that are either very distressing or result in significant disruption of functioning, as well as excessive and disproportionate thoughts, feelings and behaviors regarding those symptoms.

Somatic Symptom Disorder is a mental disorder characterized by multiple, current, somatic symptoms that are distressing or result in significant disruption of daily life. Commonly, only one severe symptom, pain is present. The individual’s suffering is authentic, whether or not it is medically explained.

The diagnoses of somatic symptom disorder and a concurrent medical illness are not mutually exclusive, and these frequently occur together.

Feelings Wheel

Emotions Wheel

  • The prevalence of somatic symptom disorder is unknown since it is a new diagnosis but estimated to be between 5 to 7%.
  • The prevalence is expected to be higher than the older and more restrictive DSM-IV diagnosis of somatization disorder (<1%) but lower than that of undifferentiated somatoform disorder (19%).
  • It affects females more than males.
  • Individuals with severe somatic symptom disorder have poorer health status scores (more than 2 standard deviations below population norms).
  • Comorbid anxiety or depression is common and may exacerbate symptoms and impairment.
  • Lower education, low socioeconomic status, adverse childhood events, and recent stressful life events are risk factors.
  • The goals of treatment are to reduce the anxiety and distress related to the somatic symptoms. Developing a therapeutic relationship with the patient is critical (“You’re suffering if real, and I want to help.”)
I am currently being advocated and supported by Marion Gilbert whose expertise is invaluable.

Somatic Awareness and Development – the Work of Marion Gilbert

“How to meet ourselves as we are, without trying to immediately change it or correct it.” — Marion Gilbert

The material below is copied from the web site of Marion Gilbert for the purpose of improving the audience’s knowledge about Somatic Awareness & Development.

Awakening the Soma

The Place to Start

The Somatic Enneagram is the relaxation of the automatic reactivity elicited through a perceived, limited reality, which is based on the need to survive, and, as was originally experienced in the past. We can choose our placement of attention, and in that, learn to extend presence and abide with the reality as it actually is. A well-developed inner observer is a prerequisite.

Through the completion of the descent from the mental to the emotional and then to the physical/instinctual impressions, we are able to find the root of the original split through the lens of perception in the Body center.  We will be able to access where our contracted, conditioned nature is located and then learn how to allow it to return to the free-flowing life force, through a “felt sense” lens of perception. We will be able to observe and understand how we are caught in a state of self-forgetting and are asleep to the unconditioned reality. The process of awakening and self-remembering, in nine different ways, is a three-centered process of descending through the three different lenses of perception: Mental, Emotional and Physical.

The Somatic or Physical center is the most difficult to access, based on its automatic, subcortical, highly conditioned survival strategies. Turning our attention inward is the first turn towards the awakening of the felt-sense and is what will build capacity for grounded presence in the present moment. The present moment is the only moment we can truly experience and through sustained present-moment awareness, we can witness transformation and the integration of our conditioned, relative nature into the unconditioned, essential nature.

What is Somatic Awareness?

The word “soma” means “body” in Greek. Most of our physical processes are designed to run unnoticed. Even the ​more obvious physical movements, like breathing and contracting muscles, are often ​​not perceived. To begin to understand the body, awareness derived from an objective inner observer is a necessity.

All initial and consequential experiences of every human being form neural pathways in the nervous system and are then stored in the brain. This complex network of communication and adaptation is designed to keep us alive separately from other beings. Without this function, we would not be able to have our life experience; and therefore, this function takes precedence over other less-vital functions.  Amazingly, the more complex aspects of our human nature are superimposed on and informed and influenced by the more primitive aspect of the brain — the reptilian brain or the instinctual brain.

Becoming aware of, and to understand the function of, the instinctual and physical workings gives us access to the automatic, subconscious and unconscious aspects of our humanness.

As we learn and grow, we are developing adaptive strategies in order to save ourselves from harm and return ourselves to functioning as quickly as possible, so we can respond to life as we perceive it. This is how our personalities are being developed, and, it’s how they become highly conditioned based on past experience and what was successful before.  When our circumstances are giving us sometimes overwhelming experiences — and there is not enough capacity in the body to respond, we learn to contain the charge of that energy, as well as shift our attention back to the tasks or demands at hand.

You may be seeing that this is related to the nine patterns of our Enneagram personality types and the adaptive strategies well described in the Enneagram system from a cognitive-emotional point of view. Also, there is a reference to the original essence for each type, which refers to a specific spiritual quality for each of them.

The underpinnings of these patterns have a somatic origin and take us to the root of the formation of these patterns.

The study and development of “conscious awareness” of these somatic patterns gives us access to the root of the arising of these patterns.  As we attain a deeper understanding, we begin to awaken to the very nature of these patterns and for what they were designed.  It’s important to know that we can learn the skillful means to choose to follow these patterns, or not, and witness the contained charge in order to safely discharge, which will free the life force and create increased capacity for received spiritual experience.

Somatic Intelligence

The Truth is in the Body

Somatic Intelligence is imbedded in our inherent physical nature. Our essence qualities are experienced in the body. Therefore, it is necessary to understand its (our body’s) nature, its workings, and the life force that fuels it.

We exist in a dualistic reality with a powerful, highly intelligent organism called “the human body.” It knows itself and it communicates its knowing all the time. It is a conduit for and inseparable from the unconditioned reality. Awakening to the messages being sent to us from the body is first, what somatic awareness means, and second, what somatic awakening is about.

Conscious somatic participation is a necessary step toward full integration of all parts of ourselves, as this is what leads to the potential for transformation, in our lives as we know it. It allows access to the subconscious and unconscious aspects of our lives, which is deeply stored in the cells. To turn our attention inward into the body is the way to a deeper knowing of “the whole self.”

Developing these capacities is the expansion of our psycho-emotional-physical ability to recognize, allow, and return to the free-flowing life force, without resisting the inner arising of the categories of perception: mental, emotional, and physical/instinctual. This is inevitably the key to attaining spiritual states of being, including emergence, manifestation, and stabilization.

How do we increase our capacity for received spiritual experience? How do we increase our ability to stay present in the moment and grounded in our beings with a compassionate heart and a receptive, clear mind?

The Enneagram suggests a three-centered approach — intellectual, emotional, and physical — for integration of the conditioned and unconditioned aspects of our humanity.

This is dependent on developing the capacity of our inner observer and the ability to relax the mind and its continual thought-pattern movements, the ability to track and recognize our feelings, and, in developing the “felt sense” awareness that is governing the automatic survival patterns.

At the root, these patterns are driven by the need to survive in the body, separate from others, which takes precedence above and beyond our emotional need for connection and our intellectual orientation that seeks meaning and gathers information by acquiring knowledge. Therefore, the higher aspects of our brain are deeply informed by somatically based survival strategies.

Working with somatic awareness practices and the Enneagram system in tandem provides a valuable set of skillful means for personal transformation.

The combination of the two provides a bridge for the physical, emotional, intellectual and spiritual realities.These practices and understandings greatly assist us to relax the identification with our personality type structure, and hence, assists us to relax our various resistances to pain and discomfort, while at the same time, developing our own connection to the somatic intelligence available to us. This provides a powerful opportunity to open ourselves to an undefended stance that is not running the automatic, highly conditioned, adaptive strategies of our Enneagram personality type. And, as a result, this gives us access to newfound levels — deeper understandings — of reality as it actually is, with greater receptivity to innate spiritual states.

What is Trauma? And How to Work with Trauma?

Working with individuals, in their bodies, it’s important to understand the mechanics of trauma resolution, as developed by American clinical psychologist and author, Peter Levine. The goal is to assist people to ​​return ​​safely to a sense of well-being, through consciously working with the capacities related to the self-regulation of the nervous system. It’s astounding that this principle works flawlessly with anyone willing to follow “the unpopular proposition,” to turn one’s attention to the place of pain and suffering within and use skillful means to access the resources in the ​​body. The titration happens ​​by shifting attention consciously, which allows for a safe and manageable ​​discharge of the overwhelm though the nervous system.

The miracle that is energy as it follows attention is witnessed and finally understood as the best-kept secret of transformation. The relief from pain and suffering is a shift of attention away.

​We can use this same principle to work with the defense system and the ​​avoidance patterns of someone’s Enneagram type structure. It’s a beautiful way in which this principle can be applied to releasing the overwhelm and allowing for our essential nature to arise. This has great value for our development as human beings.

Accessing our deepest fears — the ones that are holding us hostage, we can learn to release the deeply held tensions and defense mechanisms of the personality structure, reconciling the vice and virtues, and the fixations and the Holy Ideas, as well as what’s at the root of the defensive and the nurturing reflexes.

Our natural state of well-being then returns, and a renewed sense of grounded presence, vitality, and well-being follows.

The integration of our personality’s lower states of Dualistic Awareness and higher states of Non-dual Awareness give rise to our Essential, Divine Nature and the Benevolence of the Universe.