Somatization and Autism – Explaining Symptoms, Supporting Healing

Somatic Symptom Disorders (SSDs) are a group of psychological disorders characterized by a focus on physical symptoms that result in significant distress and impairment, even when no underlying medical cause can be identified. The person has excessive thoughts, feelings and behaviors relating to the physical symptoms such as headaches, chest pain, back pain, aching joints, gastrointestinal problems, nausea or fatigue. Diagnosis of a somatic symptom disorder doesn’t solely happen because a medical cause can’t be identified for a physical symptom. The diagnosis is based on the extent to which the thoughts, feelings and behaviors related to the illness are excessive or out of proportion.

So how does this relate to autistic and other neurodivergent individuals? Neurodivergence advocates emphasize the idea that neurological differences are a natural part of human variation and should be respected and accommodated rather than pathologized. When talking about SSDs, there can be situations where individuals with neurodivergent conditions might experience physical symptoms that are misunderstood or misattributed to their neurological differences.

A study, Health anxiety and somatic symptoms in adults on the autism spectrum, stated that somatic symptoms and health anxiety impact quality of life, but whether somatic symptoms and health anxiety correlate with autistic traits, anxiety/depression, sensory and personality characteristics has yet to be systematically investigated among autistic people. The results of this study showed that autistic adults showed greater somatic symptoms and health anxiety than non-autistic controls and these findings suggest significant somatic symptoms and health anxiety in autistic adults that warrants clinical attention.

Another study, Alexithymia and intolerance of uncertainty predict somatic symptoms in autistic and non-autistic adults, found that the autistic participants had more physical and mental health conditions than the non-autistic participants, but even when they took this into account, they experienced higher levels of somatic symptoms. The study found that alexithymia, intolerance of uncertainty, having physical health problems, being female and the number of mental health conditions predicted somatic symptoms, while interoception and an autism diagnosis did not.

Some neurodivergent individuals may have difficulties communicating their feelings or experiences, which could contribute to the perception of somatic symptoms. In light of this, mental health professionals and medical practitioners should work collaboratively to consider an individual’s entire health profile, including their neurodivergent traits, to accurately assess and address their needs.

What factors might contribute to somatization?

Author Emma wrote a brilliant post for Reframing Autism on this topic. She identified 4 factors that may contribute to somatic symptoms:

Psychological Factors: Somatic symptoms often happens in individuals who are experiencing psychological distress, such as anxiety, depression, trauma, or unresolved conflicts. This can can manifest as physical symptoms when individuals have difficulty expressing or coping with their emotions. I find this happens a lot with my autistic adult daughter. She will have headaches, perseverative thoughts, and an upset stomach from stressful situations and online communication difficulties with members from her story writing group. She often has sleep disruptions due to anxiety, causing fatigue .

Cognitive Factors: Cognitive processes such as interpretation of bodily sensations and attentional biases affect somatic symptoms. If a person experiences alexithymia or are hypersensitive they may be more likely to experience somatic symptoms. How an illness is viewed or the intensification of symptoms can contribute to somatic symptoms. My daughter has an intense focus on menstrual discomfort which affects other areas of her well being.

Biological Factors: There is evidence to suggest that biological factors, including genetics, neurobiology, and alterations in the stress response system, may contribute to somatization.

Early Childhood Experiences: Negative childhood experiences such as trauma, neglect, or abuse, have been linked to somatization later in life.

What can help with healing and fostering self-connection?

Somatic therapy is one therapeutic approach that moves toward mind-body unity rather than just mind-body connection. Instead of just talking about your experiences, somatic therapy helps you explore how those experiences live in your body. For autistic people who face unique stressors such as masking and sensory overwhelm, a body centered approach can help with healing.

Somatic therapy can be modified for autistic adults by creating a a sensory-soothing environment with soft lighting, comfortable seating, control over room temperature and sound levels, and allowing a person to stim, move or regulate as they need to.

Communication styles can be honored by using visual supports, allowing for processing time, using interests to aid understanding, and offer alternatives to face to face positioning and eye contact.

Building interoceptive awareness can help a person start to notice their internal body signals and understand what they mean. My daughter was able to describe and understand her bodily signs for anxiety at the age of 21 for the first time. We developed a plan on how to alleviate anxiety which she can now do for herself.

Learning how to regulate through the use of body movements can help. Yoga, dancing, stretching, rhythmic movement and breathing exercises can help. My son does all of these to help himself regulate.

Develop an understanding of how trauma affects an autistic person. Trauma can come from bullying, medical procedures, repeated invalidation, or just the chronic stress of living in a world not designed for their nervous system. It can increase sensory sensitivity, make a person feel unsafe, create physical symptoms such as chronic back and neck pain, fibromyalgia, migraines, digestive problems, spastic colon/ irritable bowel syndrome, chronic fatigue, and some forms of asthma. Traumatized individuals might also regularly experience disconnection with their body, muffled senses, and not have a fully integrated understanding of how they physically feel.

Physical exercise is great for reducing stress and helping with relaxation. Stress hormones typically provide energy to help us deal with extreme situations that generally require action. Traumatized individuals are regularly and unnecessarily producing these hormones and physical movement is the only way to effectively dispel and benefit from this.

There are some somatic exercises you can try in this video to reduce overstimulation to regulate your nervous system.

When supporting an autistic person through somatization, it’s important to take their symptoms seriously and understand why they may be experiencing them. Offer neuroaffirming care that doesn’t pathologize what a person is feeling, and customize therapeutic approaches to meet an individual’s unique circumstances which don’t alter who they are but rather focuses on the difficulties that can arise from being neurodivergent. This type of care care focuses on providing supports, accommodations, and skill developments that empower neurodivergent individuals to thrive authentically as themselves.

References

Emma (March 28, 2024). Somatisation: When Your Body Betrays You. Reframing Autism

Muskin, P. (July 2024). What is Somatic Symptom Disorder? American Psychiatric Association

Somatic Symptom Disorders. The Neurodivergent Collective

(August 12, 2026). Somatic Therapy for Autism: A Body-Centered Path to Healing and Self-Connection. Sage Brush Counseling